Cancer screening, prevention, and the need for better approaches

Paul L. Reller L.Ac. / Last Updated: August 03, 2017

Cancer is perhaps the scariest set of diseases facing the patient population. There is a widespread belief that a diagnosis of cancer dooms the patient to suffering and death, and a societal fear has been firmly established, almost a phobia. There is a general belief that only very harsh therapies will save only a lucky few patients, and that eventually medical science will come up with a miracle cure that can be applied to all cancer patients. The real truth is that cell mutation and cancer occurs in almost all bodies, constantly, and that most cancer goes into remission or is kept in check by the body's own homeostatic systems, and that in most types of cancer almost all cases detected are benign. We have not found oncogenes specifically responsible for cancer in 50 years of study, only a very complex array of genetic and epigenetic contributors, triggered by a complex array of environmental factors and genetic propensities. We still do not know enough about this complex field of genetic and epigenetic markers of various cancers to proceed assuredly with treatment when we do find them. There does not appear to be a simple silver bullet treatment anywhere on the horizon.

Detecting cancer at an early stage and preventing metastasis with a holistic and multidisciplinary protocol is all important, and thus better screening is imperative. What we are logically looking for in screening is a way to separate the benign and manageable cancers from those that require an aggressive treatment. Instead, screening has been used by the industry to lump together those patients that shouldn't worry with those that should. It's time to finally do right by our patients.

In 2013, extensive research by such esteemed organizations as the United States Preventive Services Task Force and the Breast Cancer Surveillance Consortium have deduced that present methods of cancer screening have not produced the hoped for results, and that a renewed focus on preventive medicine is needed to reduce cancers, especially the more prevalent breast and prostate cancers, whose incidence continues to rise in the U.S. population. In 2014, a 25 year Canadian study of almost 90,000 women, age 40 to 59, published in the esteemed British Medical Journal, found that adding mammography to screening and prevention protocol had no benefit in reduction of cancer mortality, but did result in 20 percent of these women utilizing mammography diagnosed and treated for cancer that posed no threat to their health, often using harsh therapies. Also in 2014, a study published in the November, 2014 New England Journal of Medicine outlines how aggressive cancer screening led to an enormous increase in diagnoses of thyroid cancer and harsh treatment for thyroid lesions that were not threatening. This 15-fold increase in diagnosis of thyroid cancer in South Korea did nothing to reduce thyroid cancer mortality, and Dr. H. Gilbert Welch, an author of this study that was funded by the U.S. National Cancer Institute, stated in a New York Times article that "we see an epidemic of diagnosis", not an epidemic of disease. Recognizing that attention to a broader set of signs and symptoms of cancer, and early treatment protocol that is holistic, is important is leading to better screening methods. For instance, in 2014, the U.S. FDA approved the first non-invasive screening test for colorectal cancer, ColoGuard, a stool-based test that can be self-administered, detecting an array of biomarkers, including types of red blood cells, and an array of genetic mutations that may indicate abnormal tissue and cell growths that may be precursors to cancer, or cancer itself, and can be used with another self-administered stool test, the fecal immunochemical test (FIT), which detects blood in the stool and is more accurate to rule out colorectal cancer and advanced adenomas, providing a 95 percent accuracy in this regard. When biomarkers for colorectal risk, but a ruling out of serious cancer is found, a sensible holistic protocol of cancer prevention can be utilized, with a professional CM/TCM physician providing diet and lifestyle advice, herbal and nutrient medicines, and short courses of acupuncture to decrease cancer risk while also scheduling a colonoscopy or medical exam, integrating standard and complementary medicine to provide the best results.

A mistaken focus on outdated cancer screening techniques and research to increase stressful and invasive allopathic treatments, centered on a too simplistic paradigm of genetic expression, often with serious adverse health effects, has led to development of perhaps the most important aspect of cancer prevention, integrating Complementary Medicine (CIM/TCM) to provide a host of treatments, and advice on reducing cancer risk through healthy changes in diet, lifestyle, and the environment. Modern cancer screening is finally being devised to provide a more individualized assessment of risks, and cofactors of cell mutation, and should be utilized to create a more thorough and holistic integrated care to prevent cancers. There is no "alternative" to standard medical practice, but there is a great need to integrate a wider array of conservative medical treatments and real preventive medicine.

Finally, an emphasis on quality of life, the harm and stress from current cancer screening and unnecessary treatment, and hopefully, on actual protocol of prevention in cancer care, not just early detection

Cancer screening was created to identify the relatively small percent of cases that were life-threatening or that would create serious dysfunction. Today, many cancer experts believe that instead, we have created a system of screening the general population that results in unnecessary treatment for many thousands of people who face little or no actual threat to their health, and in many cases has proven inadequate in identifying the few percent of patients that are seriously threatened in time to save their lives. A serious concern that these screening protocols have induced cancer-causing stress that in many cases may outweigh benefits, and are not linked to real cancer prevention protocols has led to a call to redesign cancer prevention and screening strategies.

Public health experts are clamoring for a rethinking of the current screening strategy, and evolving of a more comprehensive screening profile combined with an integration of preventative medicine that truly helps reverse cancer development at the earliest stage. We now know that the two most prevalent cancers in our population, breast and prostate, appear to frequently metastasize when the tissue lesions are small and generally undetectable. After years of fierce opposition, the U.S. Preventive Services Task Force and the American Cancer Society finally published screening guidelines for breast mammography and self exam in 2015 that limited the biannual mammography screening only to women age 50-74 years, unless there is evidence of abnormal risk, and to finally take seriously the individual's values regarding benefits and harm. In 2012, the United States Preventive Services Task Force, a panel of medical experts chaired by Dr. Virginia A. Moyer, also recommended that screening for ovarian cancer should be halted, as this cancer too metastasizes at an early stage. Current screening methods do not prevent deaths, but rather subject many women to severe stress and unnecessary surgeries with high complication rates when prevalent false-positives occur with chemical markers and ultrasounds. Ovarian cancer is one of the deadliest types, with 15,500 deaths in 22,280 cases expected in the U.S. in 2012, but current screening methods are not able to decrease these deaths at all. In this scenario, healthy prevention would be the key to stopping early metastases, and this means that serious consideration should be afforded to integration of Complementary Medicine. Decades of emphasis on overdiagnosis and stressful fear in cancer prevention, and a discouragement from utilizing CIM/TCM to actually help prevent cancer and cancer recurrence after treatment have not served the public well, but has created enormous profits in standard medicine.

Public health experts around the world now fear that our system of screening is not only inadequate, but has engendered a public fear and stress that itself is creating health problems and potentially contributing to the breakdown of natural defenses against cancerous cell mutations. The fear of some cancers is now so great that patients are opting to remove their breasts when precancerous cells are detected, even though greater than 99 percent (some say 99.7%) of these so-called precancerous lesions will not develop into a tumor at all. In response, standard oncology practice insists that as many as 10 percent of these DCIS lesions may contain actual cancer cells, but fails to mention that nearly all of these cancers are not aggressive. The threat level is extremely low and could be handled with less harmful treatment protocol, and less extreme fear and anxiety. In 2010, long-term studies in Europe found minimal protocol (lumpectomy with a single focused radiation treatment and removal of just the cardinal lymph node) produced the same or better outcomes than the U.S. standard of lumpectomy with extensive lymph node excision and 6 weeks of standard radiation therapy. Studies have found that a high percentage of women have been steered toward radical mastectomy and breast reconstruction because of the desire to avoid extensive radiation and lymph surgery, which is proven unnecessary. The European researchers found this practice to be unwarranted and unethical (see the links to articles on this research below). A long-term study of the psychosocial adverse effects of false positives in breast cancer screening, conducted by the Department of Public Health, University of Copenhagen, and published in the Annals of Family Medicine (Apr 2013: vol.11(2): 106-1115), concluded that 3 years after receiving a false positive in breast cancer screening, women suffered anxieties and experienced psychosocial problems equal to those women who had been diagnosed with breast cancer. These researchers found that this 2013 study was the first published study addressing negative psychosocial problems and anxiety from false positives in breast cancer screening. Clearly, a better overall method of cancer screening, and attitude about cancer and dealing with cancer, is needed. The present system is designed to create a heightened sense of fear that stimulates a great desire to remove all breast tissue when even a benign lesion is detected, and this widespread use of double radical mastectomy and aggressive non-focused radiation and chemotherapy is justified by this so-called patient demand engendered by the widespread fear and anxiety.

Despite the repeated large studies concerning the very small percentage of small calcified lesions, usually labeled ductal carcinoma in situ, or DCIS, that are detected with standard X-ray mammography, that will present serious cancer risk, the practice of this outdated screening, and the justification of aggressive biopsies and treatment, including double radical mastectomy and breast reconstruction, is still largely justified in oncology practice. Another large study is being initiated in California to once again show that much of this standard protocol is unnecessary and unwarranted, called the UC-wide Women Informed to Screen Depending on Measures of Risk, or WISDOM, led by the UCSF oncologist Dr. Laura Esserman, Director of the UCSF Breast Care Center. Dr. Esserman, in a September 29, 2015 article in the New York Times, entitled A Strong Second Opinion, stated that in the last decade she has seen a rise in the incidence of invasive breast cancer despite the removal of some 60,000 DCIS lesions each year, and that most lethal breast cancers appear between mammography screens. In response, she has recommended more time spent to individually assess the actual risk, and reassure patients that they often do not need to jump into more radical testing and treatment. The solution is obvious, a more intelligent approach to prevention, screening and individualized treatment protocols, and this new study will incorporate a Big Data approach with an array of markers for cancer, both genetic and metabolic, to refine the assessment of risk.

Dr. Esserman is also a proponent of a reworking of the randomized, controlled human clinical trial (RCT) design, with ISPY-2, which matches new drugs with patient subtypes to better assess an individualized approach, rather than the usual allopathic one-size-fits-all approach in pharmacology, that has dominated medicine for so long. Despite decades of large studies citing the failures in standard testing and treatment, and the enormous unnecessary adverse health effects and risks, with even the most conservative cancer organization in Europe and the United States now calling for a dramatic change, and the stopping of blanket labeling of all benign calcified breast lesions as carcinoma, or cancer, as well as the adherence to frequent radiation mammography and unnecessary biopsies in younger women, the field of oncology remains stubborn in its lucrative practices. These new approaches will hopefully change attitudes and also help pave the way for increased integration and acceptance of individualized Complementary Medicine. The changes to the RCT design have been demanded by researchers in the field of CIM/TCM for decades, as this medical specialty has historically been centered on individualized treatment protocols for subtypes of patients, rather than universal treatment protocols for specific symptoms or diseases. The fight between proponents of designing treatment that matches patient types and the call for a more simplistic one-size-fits-all approach goes back in time at least to Paracelsus in the sixteenth century in Europe, if not to Hippocrates himself. The debate is not new. With new study designs, we are already seeing dramatic evidence of the efficacy in a more complex holistic approach to cancer prevention and care that integrates herbal and nutrient medicine, acupuncture and diet and lifestyle changes into standard care. New RCTs are able to show how each part of a holistic approach fits into the ultimate goals in therapy, and not discount viable therapies because they are unable to be properly assessed with an outdated study design that is easily manipulated to discount CIM/TCM protocols. With improved individualized RCT design comes the potential for matching more comprehensive holistic treatment protocols to specific cancers, not sticking with binary assessments of which specific preventive treatment alone should be used.

The same type of unwarranted fear generated by outdated breast cancer screening protocols has been driving men with prostate cancer to opt for more radical procedures than are necessary in most cases. Some men are opting for chemical castration, prostate removal, or insertion of radioactive pellets when a non-specific PSA marker indicates a remote possibility of a prostate cancer creating problems. The details of current long term studies, such as the ERSCP and PLCO are provided below in the section on prostate cancer screening. There has been much concern among public health experts on the effects of this unwarranted fear for men diagnosed with insufficient data to support the diagnosis. A 2009 public health study at Harvard Medical School found that suicide rates for men diagnosed with prostate cancer was 40 percent higher than the undiagnosed group in the first year, and deaths from stroke or heart attack was more than twice as high among the men in the first month after diagnosis than it was among the cancer-free men. The study authors cited psychological stress caused by cancer diagnosis as the primary factor for these deaths. The mere fact that public health experts found it necessary to conduct such studies should tell the public that we have a real problem in this regard. The way that we look at cancer in our society and the unnecessary generation of fear rather than hope is generating a major health problem all its own. Better screening, individualized analysis, patient education, and the integration of Complementary Medicine to help achieve better survival rates and quality of life would seem to be in order. We have established a blind trust in the medical industry, driven by fear, and they have apparently dropped the ball.

There has been decades of controversy surrounding the reporting of cancer mortality, which many public health experts believes has been used to present a false picture to the public to generate funding and push expensive therapies. Currently, cancer is reported to be the leading cause of death in the United States, yet the figure represents startling facts that are not made clear to the public. The census bureau listed diseases of the heart as the leading cause of death in 2006, and the combination of stroke and heart disease, or cardiovascular cause of death, far exceeds the mortalities attributed to malignant cancer. The classification of malignant cancer as the cause of death occurs in nearly every patient diagnosed with malignant cancer, regardless of the health problem, drug cause, etc. that is primarily responsible for the actual cause of death. The fact that the patient has survived the malignant cancer for years at the time of death is often not taken into consideration. About half of malignant cancer mortalities recorded from 1990 to 2006 occurred for patients over 75 years of age, and only about 17% occurred in patients under 65 years of age. The listing of the cause of death as malignant cancer in the U.S. population per 100,000 during this time frame was 688.2. Cancer is clearly a process associated with aging, and while the population sees cardiovascular deaths as a natural cause of death, we view cancer as a different entity, one that generates great fear compared to cardiovascular disease.

For patients under the age of 65, the risk of cancer death is much less than the risk of death from other leading causes, but the fear and anxiety concerning cancer has been heightened to a degree that public health experts around that world are now very concerned that this general fear of cancer is causing more harm potentially than incidence of cancer itself in the younger population. Gradually, we are seeing our system of so-called prevention, which consists mainly of outdated early diagnostic tests, being challenged by these public health experts, and warnings that new types of generalized and nonspecific tests with genome mapping may be used to continue a heightened cancer fear, and unnecessary and unproductive therapies. This business of cancer must be turned into a better model that utilizes new technology to achieve individualized assessment and treatment recommendations that do no harm. The public must be more aware as well that true cancer prevention involves an emphasis on healthy diet, lifestyle and preventive therapies found in Complementary and Integrative Medicine and Traditional Chinese Medicine (CIM/TCM).

Patient demand may be the driving force in getting standard medicine to utilize new technology to individually assess future cancer risk early enough to encourage the changes in diet and lifestyle, and utilization of Complementary Medicine that could actually prevent types of cancer that are likely to become metastatic and are undetectable by current screening methods

Patients are now seeking better understanding of cancer diagnosis and taking a more pro-active approach to managing their assessment, diagnosis and therapy to find the best individualized outcome. The future of cancer screening will provide an ongoing and complex profile of health concerns that actually drive cancer, identify those with highest risk at an early age, and give the patient and an integrative team of physicians the ability to both prevent cancer progression, as well as identify precisely when the cancerous mutation threatens metastasis.

Just as Complementary and Integrative Medicine (CIM) has been incorporated into cancer therapy, it will also be integrated into an individualized prevention and remission strategy based on a complex screening profile. Use of screening to provide an individualized profile will allow the patient and team of physicians the chance to utilize conservative care at an early date to decrease risk in an evidence-based manner. Both chemotherapeutic agents and biologics that are individually targeted, and herbal and nutrient chemicals that are prescribed for specific and individualized treatment protocols, may be integrated to achieve greater success. This strategy, already adopted in Europe, needs to be pushed by the patient population in the United States. What the patient population wants in the United States is reassurance, not fear.

The array of individualized tests for both screening and guidance of therapy is growing yearly, presenting the public with both expensive and relatively inexpensive tests. While the prohibitively expensive tests garner the most press, many tests are being researched and implemented that are within the ability of our healthcare systems to provide to everyone. An example of prohibitively expensive testing was seen in a July 8, 2012 article in the New York Times, entitled In Leukemia Treatment, Glimpses of the Future. In this case, a cancer researcher, Dr. Lukas Wartman of Washington University in St. Louis , Missouri, found that he had advanced adult lymphoblastic leukemia, the same type of cancer that he researches, which quickly spreads through the blood cells and lymphatic system. His research team decided to perform an expensive whole genome sequencing, both comparing his normal cell DNA to the cancer cell DNA, and also sequencing his RNA, or the genes that actually produce the protein regulators in our cells. This was paid for by the research grants that his team was utilizing. Similar analyses had been performed in recent years, most notably on Steve Jobs, CEO of Apple, who paid $100,000 for the service, and which helped design his integrated treatment, using both standard cancer therapies and Complementary Medicine.

This expensive whole genome testing on Dr. Wartman found not specific oncogenes, but numerous cell mutations that could be related to cancer, both in DNA and RNA. After more than a month of extensive genome analysis, many examples of DNA mutations, untreatable with standard medicine were revealed. The mapping of the RNA also found numerous genetic mutations related to cancer, but one such mutation had already been researched and a drug developed to block its sequencing. A gene controlling RNA expression of growth, FLT3, was wildly active in his leukemia cells, and a drug, sunitinib (Sutent), had been developed for advanced kidney cancer that inhibited this RNA expression. The cost, though, was $330 per day, or over $120,000 per year, and his insurer would not pay for an unproven therapy of this cost. Dr. Wartman and his colleagues together paid for 5 weeks of the drug, and the cancer went into complete remission. This type of targeted therapy is needed in the allopathic approach to advanced cancer therapy, but not at this enormous cost. On the other hand, the present system routinely spends a fortune on nonspecific cancer therapies now proven to have limited benefit. The head of Washington University's genome institute, Dr, Timothy Ley, was quoted: "Until you know what is driving a patient's cancer, you really don't have any chance of getting it right (effective allopathic therapy)." Individualized screening and treatment testing is obviously all-important. Without delivering a chemotherapeutic or biologic that targets what is known to be at least partially driving the individual cancer, cancer therapy in standard allopathic medicine is a losing battle for most patients. The array of cancerous mutations is large.

By 2014, a number of companies have developed genetic testing for cancer that includes not just the BRCA1 and BRCA2 variants, but an expanding panel of genetic abnormalities with some link to various cancer risks. While these tests continue to find genetic mutations in only about 10 percent of patients tested, those patients are often frightened by the results, implying that they may have a particular type of cancer, and not understanding yet that these many genetic markers only imply potential for cancers, most of which could be prevented by designing an individualized preventive protocol based on these genetic risk markers.

The truth is that we do not yet know the actual risk associated with any of these genetic mutations, yet we see most patients accepting harsh anticancer therapies and a protocol of expensive and invasive testing out of fear. To counter this tendency, Memorial Sloan Kettering, the Dana-Farber Cancer Institute, the Mayo Clinic and the University of Pennsylvania have created the Prospective Registry of Multiplex Testing (for cancer), called Prompt. This registry strives to present actual updated evidence of risks for this expanding array of genetic and epigenetic markers of risk. In a September 23, 2014 article in the New York Times, entitled Finding Risks, Not Answers, in Expanding Array of Gene Tests, Professor Mary-Claire King of the University of Washington, who helped discover the BRCA1 gene, stated that the vast majority of these uncertain genetic variants would turn out to be benign, and recommended that only results with clear and definitive proof of high risk of cancer be included in these genetic reports. The worry is that many patients will be swayed by the fear of cancer and agree to unnecessary prophylactic surgery, chemotherapy or other harsh anticancer drug therapy. The clear and positive use of such uncertain evidence of potential cancer would be to guide the patient toward benign and effective preventive strategies in Complementary Medicine, but this is not forthcoming.

What is needed in cancer screening, analysis and treatment is not more enormous amounts of money fueling the status quo, but a redirection of funding and emphasis towards low-cost efficient, and individualized, testing for an array of biological markers, genetic and epigenetic abnormalities that provides specific sets of treatment recommendations. For instance, study presented at the University of California at Davis Comprehensive Cancer Care Center in 2016 showed that liquid (blood sample) biopsies matched tissue biopsies in over 400 patients with an accuracy of 94-100 percent, opening the path for non-invasive analysis of cancer type and progression. This would be just one of the many tools in screening and analysis that could be combined to find the right course of therapy. Integrating an array of evidence-based therapies that are individually designed in a comprehensive package of care will achieve the best results. Spending most of our money and effort to detect increasing numbers of benign cancers and utilizing one-size-fits-all therapies that are ineffective, and may, in many cases, be doing more harm than good, is not the future that the public desires, or deserves. Cancer screening was designed to separate the benign from the threatening cancers, but instead fueled an industry that profits from the fear of cancer, spending enormous resources in testing and treating cancers that do not threaten life, while achieving very poor results in improving prevention and decreasing cancer mortality. By both improving modern medical screening and targeted therapy, and keeping the cost down, and integrating Complementary Medicine into the package of both prevention and treatment, the future for cancer care and prevention will improve dramatically.

A Reevaluation of Standard Cancer Screening Practices in 2011

New recommendations for cancer screening in 2010 and 2011 generated much outcry in the press, but these new recommendations and guidelines came after years of delay and review of data, and are being implemented by the most conservative of health organizations and medical groups. These are not radical proponents of change, quack medicine, or controversial sources of information. What changes were implemented? Examples include the US Preventive Services Task Force (USPSTF), which proposed that mammography screening should be limited to the patient population that shows some benefit, and routine screening for all women should be discontinued. The USPSTF in 2011 proposed 2 more recommendations that concluded that typical prostate screening with the PSA and Gleason index resulted in virtually no improvement in death rates from prostate cancer and instead were very related statistically to harm to the patient with increased stress-related illness, unnecessary procedures and medications, and decreased quality of life. An October, 2011 recommendation concerning cervical cancer screenings recommended against yearly testing with PAP smears and follow-up, and instead recommended standard cervical cancer screening every three years for women aged 21-65. This recommendation was concurrently supported by the American Cancer Society, working with the American Society for Colposcopy and Cervical Pathology, and the American Society for Clinical Pathology. These long-awaited changes, already adopted in the European Union and other developed countries, strongly imply that our present system of cancer prevention and screening is not doing much good for the patient population, and in many cases is doing more harm than good to the general population. These recommendations did not come easily, as both the healthcare industry, which profits immensely, and specific patients with cancer who were helped by these screening practices, of course object strongly. These changes were not statements of failure, but rather positive steps to finally implement real and effective cancer screening and prevention, although with widespread industry resistance, these positive changes may take many years. The population itself may have to exert informed pressure to achieve the goal in a system that is intransigent and focused on maintaining status quo profits.

Even the conservative panels and organizations finally calling for change are being negatively portrayed by the medical industry, but a close look at these panels of experts reveals that they are, if anything, too conservative in initiating these changes. The United States Preventive Services Task Force is a federally mandated part of the Agency for Healthcare Research and Quality (AHRQ) and its parent National Institutes of Health (NIH) and US Department of Health and Human Services, and is made up of an independent panel of non-Federal government experts in preventive and evidence-based medicine from our most prestigious medical institutions, and are practicing primary care providers, including a range of professions from medical doctors in various specialties to clinical nursing specialists. This task force reviews and conducts scientific studies of a broad range of clinical preventive health care services. This task force is almost beyond reproach, and as much effort as is possible has gone into forming a task force independent of special interests. In 2013, a large cohort study of women of women over 40 years of age, which the the USPSTF stated may still benefit from yearly mammograms, conducted by the Breast Cancer Surveillance Consortium, and published in the Journal of the National Cancer Institute, found that women over the age of 40 that received a mammogram every 2 years instead of yearly showed no increased risk of breast cancer mortality, and experienced far fewer false-positives and unnecessary stress and medical procedures. Yearly mammograms, even for the aging woman presented a number of adverse health effects and no benefit. The decrease in accumulative radiation would also be a benefit, since radiation is a known cause of cancer.

Another source of changes in cancer screening recommendations is the National Cancer Institute of the U.S. NIH, which completed a large population-based randomized clinical trial of ovarian cancer screening which included nearly 80,000 women, and concluded that six years of screening with CA-125 and trans-vaginal ultrasound yearly did not show any statistically significant benefit in survival with ovarian cancer compared to the usual care with diagnostic investigation when signs and symptoms occurred. This study will be continued for the next few years, ending in 2015. Similar findings are expected with large reviews of other cancers, as the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening Trial encompasses a very large number of patients in all or these areas. These findings finally demonstrate that standard screening practices with radiation and other tests are not what are needed, are not effective, and in fact often do more harm than good to the population as a whole. In 2012, the U.S. Preventive Services Task Force announced new guidelines in preventive medicine that clearly stated that these current methods of screening for ovarian cancer did not produce benefits, and in fact caused much unnecessary stress and surgical procedures with risk for patients. By 2015 we finally see the adoption of new strategies, with the President's Cancer Panel, the U.K. World Cancer Research Fund, the American Institute for Cancer Research and other groups placing strong emphasis on sensible public health guidelines in diet and lifestyle, as well as decreasing environmental causes, rather than simple screening and early detection, which has largely failed us thus far in 50 years of use. Calls to adopt a more holistic approach rather than fad supplements with outrageous claims are also appearing, and utilizing professional CIM/TCM healthcare will help achieve this holistic approach and overall improvement in general health and disease prevention.

The main reason why these current screening methods for prevention of ovarian, uterine, breast and prostate cancers, and other cancers as well, are not working, is that the types of cancerous cells that metastasize quickly and cause serious health problems and death are often formed early in the process of cell mutation, and quickly spread with uncontrolled growth. Current methods of screening often detect these malignant types of cancer too late. Better screening methods are needed to detect the mutations in cells at an early stage, when tumors are too small for current screening methods. In addition to this, these findings clearly indicate that we all must strive to prevent cancerous cell mutations from occurring, not waiting until they are detected and metastasizing. Integrating a holistic plan in cancer prevention is very important. This means that preventive environmental management, preventive diet and lifestyle, and preventive medicine in all aspects, especially the utilization of Complementary Medicine, is important for all individuals, and for society as a whole.

The response from standard medicine to these failures of the present system of cancer screening has been widely publicized campaigns emphasizing the importance of the BRCA genetic mutations seen in not only breast cancer, but other cancers as well. Unfortunately, as the company that tried to patent these genetic mutations, Myriad Genetics, has revealed in their court cases, which audaciously went to the Supreme Court to try to patent a natural genetic variation in humans, but thankfully failed, these BRCA 1 and 2 genetic mutations are linked to only 5-10 percent of all breast cancers. Also, most women with the BRCA1 and/or BRCA2 mutations do not develop breast cancer. The studies of BRCA also revealed that even in cases linking BRCA mutations to breast cancer that 40 percent of these cancer cases were linked to lifestyle factors, such as early age of menarche induced by various habits, late perimenopause, high alcohol consumption, and a diet with excess fatty meats. Indeed, in 2015, after a thorough meta-review of all scientific studies, the World Health Organization (WHO) determined that processed and cured meats were in the highest category of cancer risk, and that excess red meat consumption was in the second tier of cancer risk, along with glyphosate herbicides which are paired with the Monsanto and Dupont GMO staple crops worldwide. Many of our cancer preventive chemicals are found in a fresh and varied plant-based diet, yet this aspect of cancer prevention is still not emphasized.

Such genetic tests are useful, as indicators that women with these variants, as well as men, should be more vigilant in cancer prevention and detection, but instead, the push for radical mastectomies and breast reconstruction, which does not guarantee the prevention of cancer with BRCA variants, has been widely promoted. Again, it seems that the emphasis is on fear of cancer and profiting from this fear, not utilization of new cancer screening markers to objectively and individually design improved prevention, screening and treatment strategies. Removing breast tissues does not remove genetic variants that appear in cells throughout the body, and are linked to cancers outside the breast as well. For instance, a 2006 retrospective study at the esteemed Memorial Sloan-Kettering Cancer Center in New York noted that of nearly 400 patients receiving a standard breast reconstruction between 1987 and 2002, that 3.8 percent of patients experienced a recurrence of cancer in this breast or breasts within 5 years (PMID: 16641702). The average rate of occurrence of breast cancer for women age 50 in the U.S. is 3.56 percent. These statistics could be interpreted various ways, ultimately relying on the subjective assessment of treating oncologists rather than solid objective evidence of risk versus benefit. There are almost no studies that compare the relative rates of success with radical mastectomy and breast reconstruction with equivalent women that did not receive this surgical intervention. As the U.S. National Institutes of Health notes, it will also be some years before we truly know the real long-term implications of the BRCA1 and BRCA2 positive markers. This oversimplified explanation of the BRCA genetic variants is an insult to the intelligence of the general public, and is a prime example of how the cancer industry continues to choose the wrong path forward. More selective protocols need to be implemented, utilizing a wide variety of options tailored to the individual, not a one-size-fits-all approach.

The clear message that has been transmitted to the public in cancer screening is that standard medicine has supported ineffective strategies for too long, and generated enormous costs, despite decades of data that these strategies are often both relatively ineffective and creating harm to public health. What is the message that the public and treating physicians should receive from these studies and recommendations of our most conservative cancer task forces? Namely, that we must rethink our attitudes toward cancer prevention to utilize both actual preventive medicines and dietary and lifestyle changes in public health, and utilize more benign and technological markers for cancer that supply a wealth of information which can be individually assessed to determine a graded cancer risk assessment. More importantly, as these biomarkers of cancer are utilized, patients in early stages of risk should be highly encouraged to utilize Integrative and Complementary Medicine to actually prevent the development of the cancer. By integrating standard medicine and individualized biomarkers with the large array of treatment protocols available in Integrative and Complementary Medicine, future patients will have effective and comprehensive individualized protocols to prevent the growth of cancer. To ignore this valuable research because it doesn't fit into the business plan in standard medicine is a cruel and cynical approach to public health. Patients are now demanding more from our healthcare system.

Controversies now dominate the subject of cancer screening, and the patient needs to understand the basis for these controversies to make the right choices

In 2010, the track record for standard cancer screening is not good. The two most prevalent cancers that may result in metastases and death, breast and prostate, have generated long-term comprehensive study data that suggests no benefit from standard screening for most age groups, and little benefit for the targeted age groups. An enormous industry has created unnecessary treatment for the patients that do not need any intervention, while the patients that face dire consequences have often not been identified and cured any better than those that just came to the doctor with symptoms and signs. Cancer rates have not significantly improved due to screening, and cancer mortalities remain about the same, or in some cases worse, than when widespread cancer screening started for these cancers. The vast increase in radiation screening has led to an enormous percentage of patients now diagnosed with cancer only to increase outcome statistics, and has led us to ignore better screening and prevention. Colorectal screening with colonoscopy and polyp removal has yielded some results, but with this procedure recommended every ten years starting at age 50, it is likely that patient awareness and dietary changes, as well as improved treatments, have produced the greatest results in declining mortality from colorectal cancer.

Of course, this widespread criticism of the standards of cancer screening and treatment in the United States has not gone without an outcry from the oncologists and cancer clinics that earn their living from these practices. An article in the New York Time Magazine of October 9, 2011, explicitly outlines the history of this debate in response to the announcement that the new guidelines for prostate screening that would effectively eliminate the standard practice of using the PSA and the Gleason Score to drive treatment would indeed be implemented in the United States. The article, entitled Do I Have Cancer?, quotes the chief medical and scientific officer of the American Cancer Society, Dr. Otis Webb Brawley: "I'm not against prostate cancer screening. I'm against lying to men. I'm against exaggerating the evidence to get men to get screened. We should tell people what we know, what we don't know and what we simply believe." What many of his colleagues believe is that the lucrative practice of cancer screening and treatment should not be questioned, or improved. Dr. Brawley, who is a professor of oncology and epidemiology at Emory University, is not suggesting that men should not get screened for prostate cancer, just that we should utilize screening that is logical, meaningful, and not just geared to increasing the very lucrative treatments that destroy quality of life and needlessly alarm over 90 percent of men that get a positive Gleason score. We should not sacrifice the many for the few, especially when we have better ways to identify patients at real risk of acquiring an agressive prostate cancer.

This difficult question of the risk versus benefit of specific screening practices has been unfairly depicted by standard medicine and the press (which depends upon the large advertising budgets of the pharmaceutical, insurance and medical companies) as a question of whether you are for or against cancer screening. This emotionally charged issue is handled like a religious belief, not a scientific analysis. The history of cancer screening is full of mistakes, and some of these mistakes were corrected. For instance, the New York Times article outlines how screening X-rays were promoted to detect early lung cancer and provide early intervention in the 1970s ( http://www.nytimes.com/2011/10/09/magazine/). The clinical outcomes were not positive to many oncology experts with this practice, though, and the use of radiation, a major cause of cancer, to detect cancer, was also in question. A long-term study, the Mayo (Clinic) Lung Project, found that between 1971 and 1983 that there was no difference in death rates from cancer between patients that were screened and those that were not. The researchers also found that the detection of small lung lesions by X-ray resulted in many needless biopsies and other invasive tests, as well as treatment strategies with risks for unclear diagnoses. Of course, some patients that were screened had their lung cancer detected at an early stage, but many more were harmed by the radiation accumulation, complications from tests, and unnecessary treatment. This screening was stopped.

After 10 or 15 years, though, the industry brought back radioactive tests to again screen for lung cancer, this time in the form of CT, or CAT scan, which uses up to 60 X-rays for just one test. The clarity of detection is of course better than X-ray, but the same problem with detecting small calcified lesions in the lung that are most often not cancerous growths, and the subsequent biopsies, other invasive tests, and treatments administered, again creates a risk versus benefit situation that will prove to be negative for the whole patient population. This CT screeening is utilized despite the development of more benign screening techniques, such as specialized MRI, and while screening of high-risk patients over the age of 50 has reduced cancer mortality in this subset of patients, CT screening is now increasingly routine for younger patients without a high risk as well. With the development of other screening technology, radiation is not needed, except in a small subset of patients, and then only with lower radiation spiral CT technology. PCR (polymerase chain reaction) to study specific gene mutations, testing for various biomarkers in sputum and blood, analysis of cells in sputum, fiberoptic examination of bronchial tissues (bronchoscopy), and specialized MRI, are currently being evaluated to improve lung cancer screening. The National Cancer Institute of the NIH states on its website in 2011 that "Currently, there is no generally accepted screening test for lung cancer." The five year survivability from lung cancer has been stuck at about 12 percent overall since the 1960s, and improved screening is of course necessary to improve these unchanged statistics, which have stayed the same despite advances in the screening and treatment technology.

LungCancer.org states on its website that "Although spiral CT scans can detect tumors in the earliest stages of disease, there is some debate among the medical community about whether this earlier detection ultimately saves lives. Some experts are concerned that (this) screening will lead to overdiagnosis, or the detection of cancers that would not have caused symptoms prior to the patient dying of other causes. Additionally, the procedures, such as needle biopsies, that are required to investigate irregularities on the scans can be quite invasive and have their own risks, such as collapsing a lung. False positives (the test shows something on the patient's lung even though it may not be cancer) can be common because the test can mistake scar tissue or a benign lump for cancer."

This sums up the most important question that the patient needs to consider, not only in lung cancer, but in prostate and breast cancers as well. The answer to these difficult questions in screening is not whether we give up screening, but rather that we need to develop less risky and more complex screening, and early treatment, as well as improved use of preventive medicine. In the case of prostate cancer, the New York Times Magazine article cited above states that many cancer support groups report that patients are often upset that their doctors did not ask them if they wanted to be screened, did not mention the possible side effects from treatment, and did not adequately discuss the potential adverse effects on health that often results, or the fact that more than 90 percent of patients with a positive biopsy will not have significant symptoms from prostate cancer before they die. The need for a better outcome, improved screening methods, and preventive medicine is real, but in a profit motivated health care industry, this has become difficult.

These questions of risk and questionable benefits from X-ray mammography are also in question. The answer in standard medicine is that for older women, the present dosage of gamma radiation in X-ray mammography is now so small that it is harmless. While is one sense this may be true, such a simplistic answer to the patient is not actually truthful. The present guidelines have finally acknowledged that yearly mammography, or even mammography every 3 years, in women under the age fo 40 is proven to increase the risk of developing cancer due to accumulative radiation. Oncologists are still explaining this to patients by stating simply that this radiation in younger women is dangerous, but not in older women. The truth is that radiation is accumulative, and when the accumulation of radiation reaches a threshold, the risk of cell mutation and cancer increases significantly. The fact is that for a woman over age 40 without much accumulation of cancer over her life, that X-ray mammography poses little risk, due to the small dosage. For individuals that have accumulated too much radiation in their lives, though, even a small added dose may pose significant harm. With the explosion in use of CT scans and other radiation in medicine, the ever rising levels of man-made radiation in the normal environment, from irradiating of food, airport screening, and devices that emit radiation, even large screen televisions, the levels of accumulative radiation beyond what is normal in nature, which we have evolved ways of handling in our organism, continue to increase yearly. By wearing blinders we are not getting rid of this rising threat of radiation.

The last President's Council on Cancer report in the United States emphasizes this rising threat of accumulative radiation, yet standard medicine keeps repeating a mantra of disinformation on this subject, confusing their patients. Each individual must be evaluated for potential accumulative radiation in their lives, and this should be a determining factor in the acceptance of risk for mammography radiation. The other question that is still not being addressed is the question of safer alternative. A repeating of the notion that breast cancer prevention is defined by X-ray mammography does not make this a true statement. MRI screening does not use radiation, and new MRI technology allows the use of screening machines that are small, relatively inexpensive, much more highly detailed, and allow a quicker test that does not require that the patient remain motionless inside an claustrophobic chamber. The delay in providing this advanced MRI technology, developed for the military and field use, is purely one of economics, and the pressure to continue to use outdated technology for increased profits rather than investing in new technology. In 2011, researchers at Charite University Medical School, in Berlin, Germany, showed that fast 3D near-infrared imaging using the contrast agent indocyanine green (ICG) for the detection and characterization of breast lesions can distinguish between benign and malignant lesions in breast tissues. The use of optical far-infrared imaging provides a screening device that is inexpensive, portable, involves no radiation, and does not need a powerful magnetic source. The question of why the medical industry has promoted screening with large dosage of radiation, a known significant cause of cancer, rather than such technology, is not being seriously questioned by the public.

When metastatic breast cancers are diagnosed, the use of bone scans to rule out metastasis to the bone is very important. In this test, a small amount of benign radioactive dye is injected into the blood stream and this collects in the bones. A radiation scanner is then used to detect hot spots of bone metastasis. A large majority of these scans reveal that the bones are normal, providing a relief of such fear. Almost a fourth of breast cancers that metastasize beyond breast tissue will spread to the bone, although a small percentage of these will end up with metastatic bone cancer. Most spreading metastatic breast cancer goes to the lymphatic system, and analysis with biopsy will show that these cancer cells may have gone to the 'sentinel' lymph node, which is then removed. Numerous studies have shown that for a great percentage of cases, the removal of all surrounding lymph nodes will not improve the long-term outcome, and will cause lymphedema and other health problems. The average 5-year survival for patients with stage 2 metastatic breast cancer (tumors between 2-5 cm in diameter) is about 82% and about 75% for a 10-year survival, which is very hopeful for these patients. Staging is divided into 0-4 stages, and the great majority of cases are in the 0-2 stage category. Stage 4 indicates a distant spread or metastasis, and only about 5% of women diagnosed with breast cancer are classified as stage 4. Stage 3 indicates a spreading localized advanced cancer with a tumor larger than 5 cm in diameter, and only about 7 percent of patients diagnosed are classified as stage 3. Stage 3 breast cancers that spread to the internal breast lymph nodes behind the ribs are usually inoperable, but are sometimes able to be excised. These may be treated effectively with electron beam radiotherapy to localize the tissue damage, and often a course of targeted chemotherapy is used, with 70 percent of patients disease-free after 7 years. The prognosis is very good for almost all patients diagnosed with metastatic breast cancers, and even for stage 4 at diagnosis, half of the patients now are disease-free after 4 years. Improved screening and classification, and improved monitoring, integrated with sound adjunct preventive medicine, is sure to even improve these statistics to reassure women with the diagnosis in the future. The most significant choices may be to overcome fear and to objectively make sound decisions regarding the risk versus benefits of harsh therapies in standard medicine. Choosing to do the sensible thing and individualize the treatment and prevention protocol in a more proactive manner may seem scary at first, but with increased objectivity and knowledge, and realization that you are in control and making these decisions, fear is alleviated. By remaining in the dark, fear is heightened, and the only recourse is often to try to sublimate the fear and take anxiety medications to decrease the ill effects. This is not a good solution, and the sublimation of fear, rather than the objective analysis of the fearful situation, will only make one's health worse in the long run.

Better cancer screening, classification and guidelines are sorely needed. So far, much cancer screening has not produced significant benefit, but has created many additional risks, unnecessary treatments for many patients, adverse health effects, stress and alarm, and decreased quality of life. The costs of this often ineffective screening have been enormous, not just in dollars spent and a rising cost of insurance, but in needless suffering by millions of patients that received unnecessary side effects from therapy, and enormous stress and disruption in their lives. Of course, the debate on this topic has been, and continues to be fierce, with statistics generated to support each side. What the public wants is no side taking, just a trusted and objective look at what works best. New strategies need to develop over time to improve this track record, but instead, the industry is tied to old methodology that supports the business, rather than moving on to innovative ideas that single out the few from the many, and offer a more comprehensive package of cancer therapy. Patients are beginning to educate themselves and demand that changes occur in cancer screening, detection, and comprehensive individualized therapy that produces the greatest good with the least harm.

One promising development in cancer screening is the use of protein biomarkers. While protein biomarkers present a complex set of variables that is often difficult to analyze, they will contribute to an individualized screening profile that may better guide appropriate therapies. The CA-125 biomarker is used mainly in detection of ovarian cancer, but has been found unreliable due to the fact that various factors other than cancer may cause an increase in the expression of this protein. Nevertheless, repeated tests and analysis over a period of years has been found to be helpful to distinguish those with greater risk of invasive cancer development, or metastatic cancers. When the profile of CA-125 changes in particular ways for the individual patient, further testing and screening is warranted, such as transvaginal ultrasounds in ovarian cancer. The promise of this protocol is that fewer women would be given unnecessary surgeries or other harsh therapies when cancer is suspected. A long-term study of over 200,000 women has been started in Britain, ending in 2015, with Drs. Karen Lu and Robert Bast authoring. Even before 2015, the use of biomarkers and individualized profiling and analysis will give patients and physicians much more to work with to deliver appropriate preventative medicine and anti-cancer therapies.

What the intelligent and informed patient population, and the responsible physician, wants is not an end to cancer screening, but an overhaul. Individualized thorough intelligence gathering and assessment, harmless screening techniques that provide the best data, and concurrent preventative measures taken for the patients that seem the most at risk, must be combined into a more careful and timely package of care. Screening should not be created just to sell something, but as a true preventative public service that allows the patient to make the best choices and find the most reassurance in these choices. The patient needs to take a more proactive approach to get this accomplished, and encourage a more integrated approach with Complementary Medicine.

Cancer screening is not the same as cancer prevention

Currently, there is a debate in public health over whether long-term studies have shown that the health threats from stress and worry, as well as unnecessary treatment, associated with most standard cancer screening and prevention strategies has created more damage to public health than the often meager statistical benefits of standard screening and prevention. Perhaps the most harmful aspect of cancer screening has been not just the unnecessary treatment, stress, and the array of health problems associated with this stress, but the fact that we believe that screening is prevention, and consequently ignore the subject of real prevention. Since cancer will occur in almost all of our bodies, we need to adopt a system of prevention that is ongoing and comprehensive, and not ignore prevention while we receive screening. True cancer prevention can occur both by attention to healthier mechanisms in our bodies that naturally protect us from cancer and reverse cellular mutation, and also by attention to the environment in which we live, working to eliminate the carcinogenic chemicals in our homes, community and the environment at large, such as our air and water. A less stressful environment may also contribute greatly to the prevention of cancer. Our bodies only have so much potential in them, and when we continually increase the workload, systems will fail, and with failed systems comes disease and cancer. While all of this may seem overwhelming, the effective strategy is to take it one step at a time.

In February of 2013, a U.S. congressional report, entitled Summary of Recommendations of the Interagency Breast Cancer and Environmental Research Coordinating Committee, stressed the need for a new strategy for breast cancer. The report stated: "Identifying and mitigating the environmental causes of breast cancer is the key to reducing the number of new cases."

Stressing that less than 10 percent of current research funding is devoted to understanding of environmental factors causing breast cancer, and the known fact that these environmental factors interact with even the known genetic factors, and the large majority of cases occur in women with no family history of breast cancer, the focus for decades on pharmaceuticals that may alter genetic expression, and screening for genetic markers that determine treatment, such as radical mastectomy, has been a mistake. The report concluded: "By urgently pursuing research, research translation, and communication on the role of the environment in breast cancer, we have the potential to prevent a substantial number of new cases in the 21st century." This panel of experts emphasized the need to research chemicals that act as endocrine disrupters, and physical agents, such as low-dose radiation (e.g. X-ray and CT scan), that may be playing a major role in causing breast cancer. In addition, the study of epigenetics, and a cascade of biological mechanisms, need to be better understood to show specifically how environmental factors influence breast cancer risk. In other words, a more holistic and preventive approach is sorely needed. The panel of experts stated: "Despite decades of productive breast cancer research, the number of women diagnosed with the disease continues to rise." For too long we have dismissed the array of factors that cause breast cancer and instead focused entirely on early detection and treatment. This strategy is not preventing breast cancer. A healthier environment, diet, and lifestyle is needed, as well as prevention of unnecessary social stress, and a focus on preventive medicine.

Of chief concern in public health issues related to breast cancer, the rise in obesity, with the hormonal imbalances involved, as well as the stress on the immune system and inflammatory regulation, and the poor outcomes for the black community, related to stress, diet and poverty, are now chief concerns.

This research has identified that the health of the entire endocrine system is important, not just the level of estrogens, and that the metabolic system is integral to efficient regulation of inflammatory mechanisms and immune health, which serves us daily to correct cell mutation and cancer. It is easy for an individual to say that they are not black, not obese, and not poor, so why does this affect me, but ignoring the big picture in this scenario is a big mistake. Diet, lifestyle and environmental factors are driving this increased incidence of cancer in these specific subsets of our population, and this affects us all. We need to take notice of what demographic studies of cancer risk tells us individually, as well as a nation. By adopting a healthier diet, rich in fresh, organic locally grown foods, avoiding fast food and processed foods, and adopting a more plant-based diet, more can be accomplished in cancer prevention than current screening methods. By working to restore hormonal and immune balance holistically, we can all greatly reduce our cancer risk. Getting a mammogram or PSA test does not reduce cancer risk or prevent cancer, and in fact will probably detect aggressive cancers too late for effective treatment. On the other hand, improving the diet and lifestyle intelligently, avoiding radiation when possible, and avoiding chemicals that act as endocrine disruptors and carcinogens, as well as improving overall health, the reduction in cancer risk can be enormous.

Despite a massive increase in the use of mammography to detect and prevent breast cancer, breast cancer rates and mortality in the United States continued to rise steadily until the large Women's Health Initiative study definitively showed that synthetic hormonal therapies, once touted to prevent breast cancer, were a major cause of breast cancer. Since this information became widely reported, the use of hormone replacement therapies and synthetic hormonal therapies in general have fallen precipitously, and as this occurred, breast cancer incidence stopped rising, and fell suddenly by over 7 percent. Most breast cancer organizations now report that the sudden sharp drop in breast cancer incidence around 2003 was the result of a large decrease in the use of synthetic hormone treatments in the late 1990s. The standard of practice in breast cancer prevention, mainly utilizing radiation testing and synthetic hormone replacement, both now known to be major causes of breast cancer, has been dismal. It is time for the public to demand a new and comprehensive cancer prevention system. Complementary Medicine provides the best and most comprehensive Preventive Medicine protocols in medicine, and the need to integrate Complementary Medicine is now.

Another commonly screened cancer is cervical cancer, and like breast cancer, it appeared to cancer experts many years ago that the standard screening methods were diagnosing a large percentage of cases of cervical cancer that were not actually cancer, but a type of tissue growth, or lesion, that should be monitored or removed. Unlike breast cancer, though, these guidelines were changed, and most women were told that they had cervical hyperplasia, not cancer, with appropriate measures taken to remove this tissue and prevent cancer. With breast cancer, these benign lesions were instead called cancer in situ, or DCIS (ductal carcinoma in situ), and the enormous number of women whose screening with mammography detected any calcified lesion were diagnosed and treated for cancer itself. In cervical cancer, the screening with HPV (human papilloma virus) testing was still used to determine the risk, and eventually an HPV vaccine was created that the Merck company lobbied state and federal governments to have mandated for all pre-teens and teens in the United States. In 2015, at the Chinese Academy of Medical Sciences in Beijing, China, and the Weill Medical College of Cornell University, in New York, New York, U.S.A., with research overseen by a GlaxoSmithKline Biologicals laboratory in Wavre, Belgium, newer testing methods were used to look at a large number of these samples of cervical cancer, where previously it was reported that 60-100 percent were infected with HPV. This study showed that 20-40 percent of the tissue samples in cervical cancer were not driven by cancer-causing types of HPV (human papilloma virus), particularly in older women. This study also found that in advanced stages of the cervical cancer that cancer growth and spread was not driven by HPV, and that in clear cell and endometrioid cervical cancers that less than 10 percent tested positive for HPV. In the majority of cancers, the HPV was found in adjacent tissues, but not in the tumour, and that in tumour cells, when HPV was found, types 16, 18 and 45 accounted for 90 percent of the infections (PMID: 26334557). It appears that many cases of cervical cancer are finally proven to not be caused by HPV, something that was noted decades ago but adequate testing to confirm was not conducted until 2015. The same story has emerged with the use of the PSA (prostate specific antigen) testing for prostate cancer, which is finally proven to be insufficient to make the cancer diagnosis, was never intended to make the diagnosis, but was widely used to actually diagnose prostate cancers, leading to a large amount of unnecessary treatment and stress for no good reason. This history in standard cancer screening and prevention is dismal.

All of this leads to the lack of emphasis on a real and holistic cancer prevention strategy, with the emphasis on these failed screening protocols alone, as well as harsh and unnecessary cancer treatments for many patients without actual cancer. One person that can help you a lot with this comprehensive cancer prevention is the knowledgeable Complementary and Integrative Medicine (CIM) physician, the Licensed Acupuncturist and herbalist, or the Naturopathic Doctor. More and more study data accumulates each year to help this physician deliver an array of specific herbal chemicals and nutrient medicines, as well as more general treatment to improve health and boost the potential of the immune system and inflammatory regulation to counter cancerous cell mutations. Indirect therapies may also be very helpful. For instance, patients with chronic tissue inflammation should seek soft tissue therapy to resolve this problem and take stress off of the system that also works to prevent and reverse cell mutation and cancer. Hormonal imbalances should be resolved, and a healthy endocrine state restored. Gastric and intestinal dysfunction should be assessed and proper health restored to the stomach, digestive organs, and intestines. All of this therapy, both specific to the cancers that you worry about most, and generalized to the improved function of your body, which always is the best route of cancer prevention and reversal, will reduce risk of acquiring cancer. The healthiest patients will also have the best chance of fighting serious cancers, even metastatic cancers. While even a healthy person will probably acquire cancer at some point in their life, those of us that are unhealthy, or going through an unhealthy and stressful period in our life, are obviously less able to handle the cancer and come out with a positive outcome. Recent studies on cadavers have found that nearly 90% of our bodies have evidence of cancerous growth, and about 47% of these appear to have experienced spontaneous remission without direct therapy. This happened because the systems in their bodies worked, and Complementary Medicine can help you to get these systems to work even better.

Cancer prevention in standard medicine has not utilized its greatest asset, which is the growing number of Complementary Medicine physicians and naturopathic research available and ready to integrate with standard care. One example of cancer prevention gone awry in standard medicine is the advice of nearly all medical doctors to avoid any exposure to direct sun without sunscreen to decrease rates of skin melanoma. An article in the New York Times cited below gives the current statistics of a huge rise in nonmelanoma skin cancers, and past articles have outlined the fairly dramatic rise in melanomas in the last decade. Research now shows us that this advice of total sun avoidance has created a public health problem of Vitamin D3 prohormone deficiency, which is normally produced in the body from healthy cholesterol in circulating blood with just 10 minutes of direct midday sun exposure. When this evidence came to light, most medical groups suggested that a rethinking of the concept of healthy sun exposure was a dangerous concept that was dooming patients to cancer. The reality is that a few minutes of midday sun exposure at lunch is not a threat but a health necessity. The threat of this advice was only the undermining of standard advice and the cozy relationship of the cosmetics industry with dermatology associations. Real cancer prevention is evolving and thoughtful, looking to science to reveal new ways to improve the body's ability to prevent and reverse cancerous cell mutations and enhance our natural defenses. Cancer screening and prevention is a public health issue, and should be directed by a public agency without any ties to industry.

Maintaining a healthy gastrointestinal function and symbiotic microbiota, or Biome, has been found to be integral to cancer prevention as well, and this requires a holistic approach in medicine. The U.S. National Cancer Institute and an array of University Medical Schools and Institutes have now shown the clear link between an unhealthy gut Biome and colorectal cancer, Inflammatory Bowel Disease, and expect to find a strong link to the pathogenesis of many cancers. The human Biome is now recognized as a primary component of immunoregulation and nutrient metabolism, and dismicrobism, or imbalance of this complex microbial colony that works synergistically with the human organism, is strongly linked to inflammatory disease that greatly increases the risk of cancer, autoimmune disorders, and a host of other diseases. Such imbalance of the human Biome is attributed to a variety of factors, including medications that negatively affect the gastrointestinal system, unhealthy diets, Caesarian births, poor control of stomach acidity, and unhealthy intestinal mucosa. Complementary and Integrative Medicine (CIM) provides the comprehensive and holistic approach to health that both helps to restore the microbiota and gastrointestinal health, as well as reduce to need for excessive pharmaceutical medications and alleviate adverse side effects of these medications. The CIM physician, such as the Licensed Acupuncturist and herbalist, and the Naturopathic Doctor, also provide sound individualized advice to improve the diet and insure healthy colonization with probiotic therapy.

Another aspect of evolving cancer screening that hasn't fulfilled its promise, but that could be used in the future to establish effective preventative medicine is genetic screening. Cancer research was focused on these theoretical cancer genes (oncogenes) for more than 30 years, inhibiting other effective strategies. The goal of this genetic research was to find new miracle drugs for the market. Instead, what we found was more information than we knew what to do with. There are many genes, and sequences of genes, and half genes (alleles), and even epigenes, that may contribute to various cancers, but no specific genes that we can turn off to prevent any cancer. The research does reveal some interesting facts that the patients could utilize, though. For instance, in prostate cancer, in 2009, the Cleveland Clinic website announced that current genetic research has revealed that no single gene accounts for any significant portion of the population inheriting susceptibility to prostate cancer, but that more than six gene mutations have been identified so far with links, although these account for only 5-10% of patients. Identification of such gene mutations may identify those patients that are at higher risk for acquiring prostate cancer at an earlier age, allowing those patients to concentrate on specific preventative measures early in life.

Genetic research could be used to guide and individualize this preventative care. For instance, selenium supplementation has been shown to be helpful in prevention of prostate cancer growth in some patients. Genetic research has revealed that patients with the allele AA COX2 expression had an increased risk with high dosage of selenium, and perhaps responded well to low dosage, while patients with the allele V COX2 expression had a 40% decreased incidence in prostate cancer with supplementation with high dosage of supplemental selenium.

This type of information could be used successfully to guide inexpensive and harm-free effective preventative medicine. Instead, these findings are now used in a superficial way to scare patients away from selenium supplementation. A neurotic attitude against Complementary Medicine drives such advice. The patient wants the physicians to stop this sort of behavior and work together to create a more thorough and dependable preventative prescription. COX2, or cyclooxygenase enzyme 2, is part of the inflammatory modulating cascade, and reveals that improved inflammatory modulation will be effective in preventing prostate cancer. Current advice for high risk patients is to reduce overconsumption of red meat (arachidonic acid, an omega-6), at about age 45, and consume fresh vegetables higher in lycopene and other healthy preventative nutrients. Examples of high lycopene foods include pink grapefruit, watermelon, carrot juice, and even tomatoes, which contain a small amount. COX2 inhibitors, or modulators, are found in many foods and herbs, and could help our bodies decrease excess expression of this enzyme. Examples of COX2 inhibitors include the chemicals EPA (eicosapentaenoic acid, or omega 3), resveratrol, quercetin, beta-carotene, melatonin, lauric acid, oleanolic acid, apigenin, kaempferol, curcumin, berberine, baicalein, cinnamic acid, boswellic acid, and rosmarinic acid. Many of these chemicals can be prescribed in Complementary Medicine in the form of supplements and herbs. Good use of genetic research in this regard continues to expand, providing real tools for effective preventative strategies.

The 2009 Annual Report by the President's Cancer Panel, a 40 year mandated government guide to overseeing the U.S. cancer strategy, headed by the top three cancer and public health experts in the country, selected by the President, reversed course under President Obama, and finally revealed that prevention was the most promising strategy to decrease cancer incidence and mortality. Breaking with the National Cancer Institute, which has been dominated by the pharmaceutical industry for decades, the Cancer Panel finally focused upon the need to regulate, decrease and eliminate cancer causing chemicals, heavy metal pollutants, and toxins from our environment.

While our media corporations distract the American public from the increasing carcinogenic pollution of our country by daily stories vilifying the pollution in China, the truth is that the United States is, and always has been, the most polluted country in the world. Finally, real data is presented in the President's Cancer Panel outlining the extent of carcinogenic pollutants increasing in our air, water, food, home, hospitals, and places of work. Radiation exposure, always at the top of cancer causation, has not been reduced in the past 30 years, predominantly due to the great increase in radiation exposure from medical imaging, such as X-rays and CAT scans. Nearly half of American's radiation exposure, which is accumulative over one's life, now comes from medical imaging, compared to only 18% 30 years ago. Figures such as this point to the blinders that Americans wear when it comes to problems with our own country, and the poor attitude of standard allopathic medicine when it comes to public health. With growing technology there is no excuse for continuing with use of cancer causing agents in our medical industry, our industrial production, our food industry, our farming industry, and especially our energy industry. Hopefully, the government will continue to educate the public, and individuals will take this to heart and find ways to clean up their own bodies by utilizing the increasing research into clearing cancer causing toxins, heavy metal ions, and ionizing radiation from our bodies. Complementary Medicine provides the expert information and guidance, as well as the herbal and nutrient tools to achieve these goals.

Cancer screening needs to take this advice of the leading cancer and public health experts to heart, also. The physician needs to offer more information on cancer causing agents for each individual patient, advising the patient on the importance of diet, avoidance of food with chemicals that could increase cancer risk, such as pesticides, herbicides, preservatives, and radiation (which is used commercially to improve the appearance of food and preserve it). Cancer causing chemicals in household cleaners, garden chemicals, cosmetics, and even solvents and preservatives used on flooring and decks should be avoided. Increased public awareness and education will greatly reduce carcinogenic substances in commercial use, and encourage a market for healthy products and dependable locally grown organic food, which will decrease in price when the market increases and the cost of production becomes more efficient. More information on the anticancer chemistry of foods and herbs is found toward the end of this article, and this an other information about chelation, detoxification, antioxidant clearing, etc. are available on other arthicle on this website. When individuals are screened and increased risk is noted, avoidance of carcinogens is particularly important, and increasing the body's ability to detoxify, clear and chelate potential contributors to cancerous cell mutation may be very important in the overall strategy to decrease risk of cancerous growth. A protocol emphasizing the need for a comprehensive and holistic approach is the only sensible course in reducing cancer risk.

The importance of patient education accompanying cancer screening

With cancer screening, patient education should be the first step. When patients are unclear on the procedures and science of cancer screening, fear and anxiety naturally take hold. Underestimation of the ill effects of fear and and anxiety on our health is a common mistake. More and more studies are revealing that such stress contributes to a substantial percentage of health problems in the United States. By increasing empathy and a patient-centered approach, public health researchers are finding that total health care costs can be dramatically decreased. Even in the workplace, recent studies have shown that showing true concern for the workers and decreasing stress at work with simple practices can reduce company healthcare expenses dramatically. This needs to be applied to cancer screening, which has a long history of creating excessive alarm and fear in the patients with little effective patient education.

Patients themselves are beginning to understand that a system that rushes the doctor to make snap decisions on an assembly-line approach leaves them very vulnerable to accepting the wrong therapeutic protocol, and with cancer, this can have devastating results on quality of life. When a high PSA and high Gleason score is seen, the patient should not be alarmed, but rather insist on further detailed study before jumping to the conclusion that a threatening prostate cancer is present. If these investigations lead to a biopsy, the patient should obtain a copy of the oncology report, and if needed, seek a second unbiased opinion. Specific evidence should be presented to the patient that convinces him that the cancer is indeed a fast-growing and threatening type of cancer. The oncology report should also define the cancer cell line and guide the appropriate therapy. Complementary Medicine can be utilized as an adjunct therapy, both to increase success, and to decrease side effects of standard therapies. Keeping calm and being your best advocate will insure that the most intelligent individualized course of therapy is given.

When potential prostate cancer is discovered, the patient needs to know first whether this is a slowly progressing or an aggressive cancer. Treating all cancers as if they are aggressive is not reasonable with the advance in information that we now have. This is a primitive approach that is at odds with long-term study data. Today, we have the capacity to proceed calmly and objectively to discover what type of cancer we have. If the tissue biopsy is performed and the latest technology utilized, much can be determined from the analysis of the cell physiology and anatomy. This analysis is called cytology. In Europe, cell cytology is advancing rapidly, and can individualize the treatment for each patient. Companies now have developed ways to determine which specific chemotherapy will be effective if this is needed. Cytology should reveal whether the prostate cancer is driven by local DHT, the active form of testosterone that is created locally in the tissues and drives excess cancer growth by problems with hormonal receptors. If the cytology does not reveal such prostate specific cancer cell lines, further testing must be performed to see if the prostate cancer has originated in some other part of the body and spread to the prostate. The only reason these tests are not performed in the United States is that insurance commpanies discourage thorough testing and evaluation, and encourage a one-size-fits-all approach to therapy. People with a busines degree are making these medical decisions, not people with a medical degree, and oncologist are forced to go along with these guidelines.

New developments that may lead to an array of prostate cancer markers that could be individually tailored to a cancer profile include the evidence of tissue types in precancerous lesions. All of this information is useful to establish a growth rate prognosis and for an array of therapies to be utilized that are specific to each patient. Naturopathic studies of specific nutrient medicines, and herbal research, much of which has already been performed in China, can be directly applied to cell types in prostate cancer, as well as stages of prostate cancer development. We now know that what initiates the cancer that is DHT driven is different from what speeds the cell growth and metastasis. Specific therapies can be applied from a multidisciplinary standpoint utilizing screening and assessment information, and integrated in the future. Many patients are certainly interested in expanded options, safer therapies, fewer side effects, and the best quality of life in a more thorough approach. Resistance to this this logical development in medicine can be overcome by patient input.

With some knowledge of the situation, the patient is able to intelligently discuss the screening, testing and assessment, and insure that their oncologist is taking the approach that the patient thinks is most reasonable.


Prostate Cancer screening

"The medical community is slowly turning against P.S.A. screening. Last year, The New England Journal of Medicine published results from the two largest studies of the screening procedure, one in Europe and one in the United States. The results from the American study show that over a period of 7 to 10 years, screening did not reduce the death rate in men 55 and over (the age group of almost all prostate cancer onset). So why is it still used? Because drug companies continue peddling the tests and advocacy groups push (so-called) "prostate cancer awareness" by encouraging men to get screened." Dr. Richard Ablin, creator of the PSA screening technique, in a New York Times op-ed of March 9, 2010.

Dr. Richard Ablin, creator of the PSA screening technique to assess prostate cancer risk, wrote this op-ed (opinon-editorial) in the New York Times that reflected his opinion that the test had been misused in the United States to support unnecessary treatment that did more harm than good. He wrote this op-ed in response to a rigid refusal by the United States medical industry to consider the findings and recommendations of a long-term European prostate cancer study of 2008, the ERSCP, that was supported by an NIH study in the United States called the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) on prostate-cancer mortality. These European experts concluded that long term studies showed no significant reduction in prostate cancer deaths from the present regimen of screening and therapy, but unnecessary treatment in 98 percent of prostate cancer patients that diminished quality of life, and called for a new system of individualized evaluation that would do a better job. This report was met with much hostility in the United States, and a political, rather than scientific, response, that reflected a desire to continue with a profitable screening and treatment strategy rather than to change to a more patient-centered approach. Despite the many articles that criticized the new European guidelines for testing and treatment, and now the vilifying of Dr. Ablin for his support of these new guidelines, patients are looking for the actual facts that will help them to choose the best course of action.

The European Randomized Study of Screening for Prostate Cancer (ERSCP) was initiated in the early 1990s to evaluate the long-term effects of screening with prostate-specific antigen (PSA) on the eventual outcomes for patients. PSA is a non-specific glycoprotein marker in the blood circulation that indicates a potential problem with prostate function. PSA is primarily produced in the prostate gland and serves to help liquify the ejaculate and semen to allow the sperm to swim freely to increase chances of fertility. PSA is also a protease, or protein enzyme, that increases the rate of dissolving of coagulation and mucus, and allowing more sperm into the prostate fluid ejaculate. PSA is normally found in blood circulation at very low concentration, and there is some correlation with high PSA levels in blood circulation and the presence of prostate cancer, however, PSA elevation is by no means a clear and certain indicator of prostate cancer. PSA is expected to rise with age, and is expected to spike under a variety of circumstances. In a March 1, 2011 article in the New York Times, a professor or radiation oncology at Harvard, Dr. Anthony D'Amico, confirmed that PSA levels routinely spike with sexual activity, riding on a bicycle or horseback, with bladder or prostate infections, after a colonscopy, an with other types of stimulation. PSA spikes are often the result of differing ways that laboratories perform the PSA testing. PSA is not a true specific antigen to prostate cancer, and this name should be changed. PSA was never intended to be a marker that would confirm prostate cancer, but merely an inexpensive screening that would separate men with risk from those without risk.

Jumping to 2010, from the 1991 initiation of PSA testing, nearly 20 years later, the screening has failed to decrease cancer mortality, which should be a cause for concern. In fact, age-adjusted studies of prostate cancer mortality in the U.S. population have not significantly changed since 1949. The ERSCP study found that for every potentially serious cancer patient found in extensive testing, that 47 men with no risk of mortality from prostate cancer were subjected to unnecessary treatment that resulted in serious health problems, such as loss of sexual function, urinary problems, anxiety, and stress related health problems. There was a call by the experts for a more reasonable screening method. In Europe, medical doctors almost unanimously opted to explore new methodology in prostate cancer detection and treatment, individually assessing each patient for risk and discussing the probable outcome, which for 97% of patients involved a very slow progression of a cancer growth that stayed localized to the prostate, and caused minimal symptoms up until their natural death. It was never suggested that these patients receive no care. It was never suggested that patients with a spreading prostate cancer be denied care. It was never suggested that patients not be given effective prostate screening, which involves manual palpation of the prostate and utilization of tissue testing, such as ultrasound, MRI, and eventual biopsy, if warranted. In the United States, the medical doctors instead increased the dependence on PSA counts to guide harsh therapies, often utilizing chemical castration, or chemical stopping of hormone production, and other anti-hormone therapies, even before there was any evidence of prostate cancer that was driven by hormones. Many other patients are given insertion of radiation pellets and surgical removal of the prostate when it is unclear whether their cancer is indeed threatening, mostly based on outdated PSA screening. Instead of opting for a simpler and more direct approach to screen potentially serious cases, a formula of risk screening was built around the PSA counts that was difficult for even the prostate cancer specialists to understand, and harsh therapies were prescribed for almost every patient with a poor score on these tests.

Normal PSA levels of 4 ng/ml in the circulating blood were established by a single small study in 1986, where the company that was selling the test, Hybritech, distributed the data that claimed that 99 percent of normal men (472 health and relatively young men were used in the study), maintained a PSA level of 4 or lower. In subsequent studies, it was found that men with a variety of health problems, and even sexual habits, could elevate this PSA count, and that a significant percentage of men with prostate cancer did not have an elevated PSA count (18%). It was also later found that normal PSA in the over age 70 population was higher, at least 7.4.

The list of factors that could cause an elevated PSA in the absence of prostate cancer includes obesity, prostate infection, prostate irritation, benign prostate hyperplasia, recent manual digital exam, recent surgery, and even recent ejaculation. Frequent ejaculation could also account for a percentage of the high PSA counts. The company that did the original study knew these facts and screened the study participants to exclude any of these cases. Medical doctors still do not usually discuss these potential factors that could cause high PSA counts with their patients. Dr. Hablin, in his op-ed article, states that even use of ibuprofen, as well as other over-the-counter drugs, and even other infections in the body unrelated to the prostate, are now known to be able to elevate the PSA levels in testing. Screening guidelines utilizing PSA counts established by the pharmaceutical industry are not adequate to insure accurate results to guide therapy with harsh side effects and diminished quality of life. A number of the most prominent cancer organizations, as well as the inventor the PSA test, have recommended that PSA testing be severely curtailed to decrease the enormous stress and unnecessary procedures and wrong diagnosis and treatment instigated by the PSA testing as a diagnostic criteria.

In 2008, the U.S. Preventive Services Task Force recommended against any PSA testing for all men over the age of 75, because almost all prostate cancers were slow to metastasize and almost all of these older men would die of other causes before the cancer killed them. Instead, the medical industry just increased the PSA testing, especially for men over age 75. In 2012, in response to renowned international organizations presenting even more evidence that this screening with PSA in fact created more harm than good, the Task Force recommended against all PSA testing for all men, and the adoption of other screening and preventive measures. The medical industry in the U.S. again pushed back, and the percentage of all men screened with PSA testing fell only from 44 percent o 37 percent, with those 75 and older still screened in 38 percent of all men, despite a decade of evidence that this just presented a false scenario, and unnecessary stress, fear and treatment. In a New York Times article of May 24, 2016, entitled Those Persistent Prostate Tests, it was reported that surveys show that almost all men report that their doctors informed them of the advantages, but only about a quarter of patients remembered any mention of disadvantages. A great majority of patients tested positive, even when informed that the prostate cancer was benign, opted for surgery or radiation, because the mere mention of the word cancer now carries incredible fear. Dr. Victoria Tang of the University of California at San Francisco, stated: "A PSA test is not just a blood test, it's signing up for a prostate biopsy if the screening is positive, and that biopsy can cause pain, bleeding, infection." Today, hospital infections now are frequently occurring and involve an antibiotic-resistant bacteria. The biopsy finds prostate cancer in about 30 percent of men with positive PSA tests, and almost all of these cases are either benign or so slow to metastasize that older men will die of other causes before the cancer becomes severe. When these recommendations to switch to other diagnostic markers of prostate cancer and cancer risk were made in 2008, the medical community in the U.S. instead created a more elaborate PSA protocol and provided misinformation that more men die of prostate cancer than women of breast cancer. Bending the statistics could provide some truth to this spin, but it is quite the stretch. Nevertheless, this advice from M.D.s was almost universal. Dr. Scott Eggener, a urologic oncologist at the University of Chicago was quoted in response to the persistently high habit of screening with PSA: "That's just insanity, bad medicine, poor use of health resources, and poor decision making." By 2016, we should be using more nuanced markers of disease, and finally adopting real preventive medicine. The continued PSA protocols just tell the patients that they can skip all that preventive work and just wait till the PSA test and Gleason score is positive, and then receive a biopsy, surgery, radiation and hormonal ablation, despite this scenario being devastating for quality of life and only helpful for a few percent of those that undergo this protocol. Poor results are not the only results, and we cannot justify the past protocol because it has some poor results, ignoring the enormous harm to quality of life. Prostate cancer preventive protocols, even in CIM/TCM are very effective and now proven so, they are just not touted, or even mentioned by most U.S. Medical Doctors, and in fact still discouraged as "dangerous alternative medicine". This is ridiculous.

Evolution of the current screening protocols in prostate cancer

In the last ten years, a large number of medical doctors read these facts in the United States and suggested that a better system be implemented. It was found that PSA velocity, or the fast rise of PSA counts on multiple repeated tests be used as a more specific marker before alarming the patient and proceeding with drug therapy. This seems perfectly reasonable, yet was rejected outright by most clinics and hospitals. They argued that the PSA velocity would delay treatment, since this testing involves monitoring the PSA for up to a year in most cases (although slow growth implies less threat). Another reasonable tactic suggested by informed and free thinking medical doctors was the use of a free PSA test. Most PSA in blood circulation is bound to protein carriers, and studies revealed that the ratio of free PSA to bound, or total PSA, was a more reliable indicator in long term studies of potential prostate cancer patients. This test marker was also usually not performed and discussed. When it was performed, the patient often was not asked whether they had ejaculated in the last 24 hours, which would raise both the free PSA and total PSA dramatically. If this was discussed, patients report that the question was asked in a casual way, and often the patient was then embarrassed to discuss their sex life, and often said no, with no real idea of the importance of the fact that they had masturbated within 24 hours. What was adopted was the Gleason score, which is difficult for the patient to understand, and sometimes even the medical doctor.

Even in 2011 there is still alarm in the community of prostate cancer experts concerning the number of useless biopsies and misuse of prostate screening tests to generate these unnecessary biopsies, and high incidence of stress and anxiety associated with them and the threat of prostate cancer. An article in the March 1, 2011 New York Times, entitled "Prostate Guidelines Said To Cause Useless Biopsies", cite the leading experts in the field decrying the current use of prostate cancer screening guidelines to generate useless biopsies. After the larger studies found that the PSA testing and standard one-size-fits-all PSA score, as well as the difficult Gleason Score, were problematic, many oncologists in the U.S. started using the PSA velocity, sometimes alone, as a guideline for suspected prostate cancer and need for a biopsy. The article cites cancer experts at Harvard and Sloan-Kettering, who state that many oncologists in the U.S. are now using guidelines that generates biopsies with a single increase of 0.35 nanograms of PSA in a year, when the PSA is in excess 4.0, and often even when the PSA is normal for a healthy young man, or under 4.0. A single yearly rise in PSA could be attributed to many circumstances, as stated above, which every M.D. understands now, and a rise in PSA, or increase in PSA velocity, alone, routinely occurs in men, as does fluctuation of the PSA. The misuse of the PSA velocity test is now so widespread that Dr. Andrew Vickers of Sloan Kettering, who authored an extensive study of the misuse of PSA velocity in oncology, published in the March 16 issue of the National Cancer Institute, stated that the PSA velocity test should perhaps be eliminated from cancer screening due to the widespread misuse of this test generating scores of unnecessary and useless prostate biopsies. The sage seems endless.

There are now many screening methods other than PSA and Gleason Score to assess prostate cancer. The trans-rectal ultrasound (TRUS) is a safe and effective way for the specialist with minimal training to examine the prostate for small growths and tumors, and monitor cancer growth when detected. Preprostectomy MRI, or combined MRI-MRS (spectroscopy) are also useful in differentiation of clinically significant from clinically insignificant disease. Other markers that have been used are PAP, PSADT, PSA RE-PCR, DHEA, Testosterone, Prolactin, CEA (carcinoembryonic antigen), CGA (chromogranin A), DNA-Ploidy, Ploidy, and NSE (neurospecific enolase). This menu of screening is being developed in Europe to individualize the patient risk and guide an appropriate therapy. These various tests and markers are best used in an individualized manner, providing information and profile that can be utilized over time. Unfortunately, the U.S. has a medical system based on what the insurance company allows, not what is warranted by science, and here this array of tests is rarely approved for payment. Oncologists have given up even requesting it.

What drives the initiation of prostate cancer is different than what drives the rapid growth later in the cycle. Some patients may have different hormonal imbalances that increase risk. While we try to use PSA and Gleason score to identify patients with prostate cancer that is already threatening, some of these other markers could be used to identify patients before the cancer develops into a threatening stage, and gives the integrative team and the patient the time to consider various conservative and preventative strategies. This protocol would put the patient's mind at ease, rather than unnecessarily alarm him, and allow a positive and proactive strategy to decrease risk. Complementary Medicine, and many responsible M.D.s are now turning to other laboratory testing, such as active hormone metabolite and biomarker screenings, to improve the assessment at an early stage and guide preventative care or treatment. The Licensed Acupuncturist can also order these inexpensive tests, which are performed utilizing saliva and veinous blood stick sample collected by the patient. Unfortunately, in most cases, the insurance authorization is still hard to obtain, and many patients pay a reduced price out of pocket to the lab.


Breast Cancer screening

Mammography, or X-ray radiologic study of breast tissue, has long been the trusted screening method for breast cancer, despite years of reasonable objections. X-rays produce radiation, and radiation is the number one cause of cancer cell mutation, and is accumulative in the body. Yearly X-ray analysis has seemed like an illogical methodology given this basic fact, and was widely accepted in the past because there was no better screening method available. In 2009, breast cancer authorities stated that national guidelines should be changed to at least discontinue these mammographies in younger women, due to the conclusions of little or no real benefit by long term study analysis, and the potential for the radiation to add to cancer risk. A similar conclusion was reached for women under 40 in 1999, and was also met with much objection, which caused a reversal of these guideline changes. Once again, the point was not to deny women information with screening, but to enact positive changes to our screening and prevention protocol based on new evidence and technology.

In 2013, a large cohort study of women over the age of 40, involving over 140,000 women, from 1999 to 2006, gathered for the Breast Cancer Surveillance Consortium and published in the Journal of the National Cancer Institute, found that yearly mammograms for women over the age of 40 did not result in reduced risk for breast cancer mortality over mammograms conducted every 2 years. These researchers found that a number of adverse effects were associated with yearly mammograms, including a higher incidence of false-positives, generating harmful fear and stress that negatively impacts health (JNCI 2013, Feb 5; Braithwaite D et al). In 2014, a 25 year Canadian study of the efficacy of X-ray mammography was published in the esteemed British Medical Journal, with nearly 6000 women followed, half choosing mammography in their screening protocol, and half choosing not to use mammography. These women, age 40 to 59, represent the current targeted population for yearly or bi-yearly mammography. The results showed no significant difference in the rates of mortality from breast cancer between the two groups, but did point out that 20 percent of the women who were screened with X-ray mammography were incorrectly diagnosed with threatening cancer, or a metastatic type. While almost all women diagnosed with invasive cancer after mammography and biopsy understandably believe that they did have a threatening type of cancer that required harsh treatment to save their lives, this study revealed that about 20 percent, or 1 in 5, actually did not have a threatening type of cancer. Such studies have been thoroughly peer-reviewed and are prompting some countries to remove X-ray mammography from their screening protocols altogether. This does not mean that countries like Sweden will stop breast cancer screening, only that they will stop methods now proven to be of little benefit and actual risk of harm. In these countries, breast cancer screening will evolve with current knowledge and technology, providing better protocols.

Other alarming news has also surfaced in recent years. Genetic markers were touted as firm indicators of risk for a few years, resulting in a large number of preventative mastectomies that were not justified. Some experts in the field adopted a belief that many women were probably preprogrammed genetically to breast cancer, but most specialists argued against such an assumption. Genetic study has now revealed the complexity of genetic propensity for disease and cancer. Not only are a wide number of genes implicated that must work in a sequence that we do not understand, but there is also an epigenetic control of these various genetic expressions that is even more complicated and hard to analyze. No specific oncogenes have been identified that guarantee that the patient will acquire cancerous mutations. The findings that the BRCA type 1 and 2 mutations may be associated with up to 70 percent of patients acquiring a form of breast cancer by age 70 must be assessed fully, without jumping to alarming conclusions. Patients must keep in mind that only about 5 percent of breast cancer patients have these genetic mutations, that many type of BRCA1 and BRCA2 mutations are not harmful, that radical mastectomies do not remove the gene mutations from the rest of the cells in the body, that types of BRCA1 and 2 genetic mutations are associated with other types of cancers, so radical mastectomy does not remove this threat, and lastly, that overall, about 13 percent of women will develop breast cancer sometime in their lives, and that the percentage of women who used synthetic contraceptives or hormone replacement therapies, received excess accumulative radiation in their lives, suffered obesity, had abnormal menstrual history, experienced fibrocystic breast tissues, and/or had a close family history of breast cancer, had a much greater risk of acquiring breast cancer by age 70. Patients with potential genetic alleles may also have a wide variety of inheritable mechanisms to help prevent the cancerous cell mutations. Genetic study and evolving findings were not used in a responsible manner. This information should have been adding to screening information to carefully piece together an individualized assessment. Instead, the genetics were used to drive a market, and take advantage of a societal fear to rush to unnecessary harsh treatment, all justified by the belief by a few that some women were perhaps biologically predestined to cancer. The belief was conclusively denied by further genetic study.

In 2009, the American Cancer Society stated: "Women have already begun to benefit from advances in understanding the genetic basis of breast cancer. Genetic testing can identify some women who have inherited mutations in the BRCA1 or BRCA2 tumor suppressor genes (or less commonly in other genes such as PTEN or p53). These women can then take steps to reduce their risk of developing breast cancers and to monitor changes in their breasts carefully to find cancer at an earlier, more treatable stage." Such genetic markers do not doom the patient to breast cancer, but do point to the need for the patient to take a more proactive approach to suppress cancer mutations in their body, and allow the patient and physicians, including Complementary Medicine physicians such as Licensed Acupuncturists and herbalists, to start preventative medicine at an earlier date. Simply removing the breast tissue (radical mastectomy) and cosmetically reassembling the breasts has not been shown to be a sure preventer of breast cancer for these women, and these genes have been linked to increased risk of other cancers as well, such as ovarian and uterine cancers. By acknowledging the increased cancer risks and doing more to help your body prevent such cell mutations and growth, this risk is greatly reduced. Even if radical mastectomy, hysterectomy, and oophorectomy are chosen, this does not guarantee that these cancers will not occur, and use of preventive measures with Complementary Medicine may be essential to your peace of mind.

What do the genetic markers for breast cancer tell us? The BRCA1 and BRCA2 genes are involved in DNA repair, and interacts with other proteins, such as RAD51, to aid the continuous process of DNA repair. If repair of DNA does not keep up with damage to the gene, more mutations may occur, leading to increased risk of a cancerous cell. It is estimated that the BRCA1 and BRCA2 genetic markers increase the risk for all cancers in reproductive organs by up to 60 percent, but most of this increased risk occurs in old age, after age 70, not in young women. RAD51 may also be an important genetic marker, as this protein is expressed to aid DNA repair, and appears to be somewhat controlled, or modulated by the BRCA2 genetic proteins. Increased expression of RAD51 has been associated as a marker for increased breast cancer risk, not because RAD51 is a bad protein, but overexpression identifies a lack of BRCA2 control. Hundreds of mutations have already been identified in BRCA1 and BRCA2 genes, and problems with these gene functions are associated with risk not only for breast cancer, but uterine, ovarian, and even in prostate cancer, and are associated with types of lymphoma and leukemia as well. Research has shown that specificity of the type of cancer linked to these genes is related to environmental triggers, such as carcinogens and chronic inflammation. In the past, many young women were frightened by the finding of these genes, so much so that they opted for a radical double mastectomy, and research in the last decade has shown that most of these radical mastectomies were unwarranted. Today, there is the potential for using better DNA testing, such as Q-PCR, Quantitative Multiplex PCR of Shorts Fluorescents Fragments (QMPSF), and Ligation-dependent Probe Amplification, to detect the specific type of mutations on these genes, and provide a more holistic analysis of what could be done to prevent the problems that are associated with increased cancer risk. Given that most women with breast cancer do not have a family history of breast cancer, these genetic markers obviously are not the sole answer to increased cancer risk. The problems that trigger the BRCA1 and BRCA2 mutations are perhaps more important, and preventive medicine and stricter environmental regulation may reduce these cofactors dramatically. Complementary Medicine may also provide much aid to the ability to better repair these mutations to BRCA1 and BRCA2, as well as to aid DNA repair when these problems are found, and to decrease the triggers of chronic inflammatory stress and cell toxicity. Early screening with such genetic markers should provide the means to reduce cancer risk without resorting to radical measures, such as the surgical removal of the breasts. In fact, even a double radical mastectomy may not provide a clear prevention of cancer. as the remaining breast cells, and cells in the ovaries, fallopian tubes, and uterus may still be affected by mutations in the BRCA1 and BRCA2 genes. No matter what the patient decides to do, there is an important role for Complementary Medicine.

The fear of breast cancer has driven both patients and doctors to jump to conclusions and adopt harsh preventative measures before all of the information is gathered. In recent years, the discovery of estrogen receptors has created an entirely new adoption of harsh treatment regimens, with drugs that block hormone metabolism. As research on this subject revealed that the hormone conversion in the local tissues was mostly responsible, not the systemic estrogens, and that hormonal imbalances and inflammatory responses were driving an imbalance of cellular receptors that delayed normal cell death, or aptoptosis, creating more of a chance of serious cell mutation, these new findings were largely ignored. Expensive drugs had already been created and marketed based on old information, and guidelines and an industry had been created with tremendous momentum that could not be stopped. There has been a reversal of this widespread adoption of harsh medications based on hormonal receptor study, though, and it has come from an increasingly skeptical patient population. The harsh side effects of hormonal ablation are becoming well known in the society, and a belief in the doctors that assure that these drugs are benign has been undermined. While it is not suggested that women completely abandon hormonal anticancer therapies, there needs to be a more individualized approach that does not overutilize these drugs.

What is the solution to creating more effective cancer screening? Currently, simple palpation exams find the majority of growing tumors, and newer MRI technology is becoming cheaper and shows much promise in detecting very small tumors. Progress needs to be made distinguishing small calcifications into benign and potentially malignant with biopsy and histology. As stated, a menu of exams and markers can be utilized, just as in prostate cancer, to give individualized assessment and guide therapy. The savings in stopping unnecessary care would more than pay for the increased costs of the better screening, and a more conservative integrated care could be initiated for slow growing and less aggressive cancers. Early screening assessment could guide specific therapies utilizing herbal and nutrient chemicals, as well as indicate need for improvement of hormonal balance, metabolic homeostasis, and inflammatory regulation.

A majority of invasive breast carcinomas are thought to evolve from pre-existing benign breast lesions, and currently, 80% of all breast biopsies show benign breast lesions, with a great majority of these not associated with developing breast cancer. The term benign breast lesion encompasses a large array of tissue types, and the recent use of the term precancerous lesions has created much unnecessary alarm. The term in-situ carcinoma for some of these lesions with distinct morphological type has been highly controversial, as these tissues are not technically carcinoma, and many experts have claimed that the use of the term was created purely to cause alarm and sell procedure. In recent years, a growing percentage of all new breast cancers diagnosed and treated are DCIS (ductal carcinoma in situ). New molecular studies have suggested that this tissue type exhibits only one of the potential pathways of the complex mechanisms of breast cancer development. In addition, studies at prestigious cancer clinics, such as Sloan-Kettering, has found that different labs produced different morphological assessment of these in-situ lesions. Still, fear of breast cancer has driven many women to jump to the most radical solution, double mastectomy, despite the fact that even mastectomy might not prevent cancerous growth and spread if the cancer is indeed invasive, and the stress of mastectomy and reconstructive surgery, with implants, actually has the potential to stimulate cancer growth. As always, the guidelines do not reflect the complexity of the situation, and do not adequately consider the individual parameters of each case. There is much a woman can do to decrease risk of developing cancer after the so-called in-situ carcinoma is diagnosed, though, even when mastectomy is chosen, and research in Complementary Medicine should not be ignored in the individualized protocol.

An article in the July 20, 2010 New York Times elucidates the current problem with diagnosis of DCIS. Experts such as Dr. Shahla Masood, the head of pathology at the University of Florida College of Medicine, states that "There are studies that show that diagnosing these borderline breast lesions occasionally comes down to the flip of a coin. There is a 30-year history of confusion, differences of opinion, and under- and over-treatment." The link to the full article is presented in additional information below. The readiness of many oncologists to take questionable biopsy results of questionable cancers and present this to patients as firm proof, shows many patients that they need to be wary and adopt a treat and monitor approach, rather than to jump to conclusions and let their fears drive radical decisions.

How can the threats of so-called in-situ carcinoma of the breast, which is actually non-invasive potentially precancerous microlesions in the milk duct tissues of the breast, be explained more clearly and simply to the patient? This is a question that was addressed in a 2010 report published online April 27, 2010, by the Journal of the National Cancer Institute, and reported by the New York Times (link to article below). The biomarkers p16, COX-2, and Ki67 were identified as the key markers for more accurate prediction of risk for these cancers. If the woman tests positive for all 3 markers, a woman has a potential 20% risk of developing an invasive cancer within 8 years. When these 3 markers are negative, the woman has a determined risk of developing invasive cancer of only 4%, while the general population in the age group over 45 being reviewed, has a 3% determined risk. Individualized profiling in the future could also divide these groups more accurately in those more at risk. For women that determine that the risk is less than the harm of standard therapy, there is now an individually tailored safe and effective treatment protocol in Complementary and Integrative Medicine that is growing each year with new research.

What do these important biomarkers now tell us about our bodies? COX-2, or cyclooxygenase-2, is a common inflammatory mediator that helps our immune system determine the rate of inflammatory processes. COX-2 is a protein that is able to synthesize increased prostaglandins, and is useful in the inflammatory cascade to rapidly counter inflammatory processes to moderate them. Overexpression or accumulation of COX-2 may lead to changes in the tissue epithelium and promote growth factors associated with various cancers. In coordination with other chemicals, COX-2 overexpression can also inhibit programmed cell death, or apoptosis, increasing the chance that older cells undergoing normal mutations with aging will become cancerous. Precancerous lesions may overexpress COX-2 to counter chronic inflammation due to irritation by these calcified lesions, and it is found that cells that are stimulated excessively by certain estrogen receptors may also overexpress COX-2. While many breast cancer sites now state that COX-2 is a form of the inflammatory mediator associated with cancer, this is misleading in its implication that COX-2 is not expressed outside of cancer cells. The fact that a number of COX-2 inhibiting drugs were invented (Vioxx et al) for all chronic pain, and in fact taken off of the market due to extreme risk and damage by upsetting the normal inflammatory processes and leading to cardiovascular degeneration, tells us that COX-2 is a widely expressed inflammatory mediator outside of cancerous lesions. There is now a wide array of studies on natural COX-2 inhibitors found in herbal medicine that have proven to be safe and effective. Another biomarker, p16, is a tumor suppressor protein, called cyclin-dependent kinase inhibitor 2A, that plays an important role in regulating the cell cycle and correcting the cell mutations that lead to a variety of cancers, most notably melanomas. Ki67 is a protein that may be necessary for cellular proliferation, and overexpression may therefore by linked to tumor growth. Ki67 will not be seen in all cells of the precancerous lesions, but if it is found in too many of the cells, this is a marker that signifies that the small lesions may develop into a faster growing cancer over time. Understanding of these relevant biomarkers leads to advanced research in ways to safely decrease these cancer processes with herbs and nutrient medicine. Since the development of these cancers is slow, many patients have time to utilize this research and benign therapy to decrease risk.

One important consideration in individualized protocols for women with a higher risk is age. With slow growing cancers and risks well in the future, many women may decide that at an advanced age it may be a choice to try to prevent the cancer with healthier protocols, and avoid the stress of standard therapies, especially the stress of radical mastectomies and radiation. Such stress in the older woman may have serious consequences, and it is hard to determine whether such stress will in fact lead to decreasing the body's natural defenses against cancer. No studies actually examine the potential of harsh therapies to induce cancer. There is no funding for studies that would produce negative data on the therapies. One example of this dilemma is the recent findings that standard CAT scans, which incorporate a relatively high dose of radiation with repeated X-ray slices in tissue study, actually cause thousands of new cases of cancer per year. The U.S. government is finally producing new guidelines to limit the use of CAT scans, and better guidelines to prevent mistakes with inadvertent high dosage of radiation. Radiation therapy itself in cancer protocol has recently been scrutinized and found to result in many cases each year of improper dosages and errors leading to serious injury. The New York Times in 2010 published a series of articles outlining these problems with radiation in therapy. Before this, both patients and physicians seemed to operate on the assumption that radiation in diagnostics and treatment had no significant risks and injury. The patient that is advanced in age takes these factors in consideration as a carefully documented individualized assessment of risk versus benefit is put together. Often, the patient may choose to utilize therapeutic protocol with less risk, even if the proven benefits are not as well documented.

While our science emphasizes study of those women that develop cancer, we largely ignore study of those women who avoid it. Patients are starting to question this emphasis, though, and trying to find out what they can do to be the 97% of women over the age of 45 not expected to develop invasive breast cancer. There is also an abscence of study of those women who are diagnosed with invasive breast cancer and survive beyond 5 years. A New York Times article in the April 26 Science Times follows a woman that is surviving grade 4 invasive breast cancer after 25 years. The article makes clear that there is almost no study of breast cancer survival after 5 years, and her doctors state that they see a small percentage of this most serious type of breast cancer survive, but they have no understanding of what differentiates these patients. Studies of long term outcomes in surviving breast cancer continue to be dominated by aggressive pharmacological approaches, with increasingly complex explanations for using harsh drug therapies continuously for many years, largely ignoring the adverse health effects and risks of pharmacologically induced cancers. So many very large studies have shown how this approach has been disastrous, with hormone replacement strategies with synthetic hormones proven to be responsible for so many cases of cancer, especially breast cancer, and with long-term use of other hormonal therapies also shown to be responsible for so many cases of uterine and ovarian cancer. We still have a dominating view in standard medicine that estrogen therapy should be used in post-menopausal women, and repeated views that the review of the famous Wormens' Health Initiative study that showed that women who used bioidentical equine-derived estrone, called conjugated equine estrogen, or Premarin, showed a long-term decreased risk of breast cancer in their 60's and 70's, was a statement supporting the use of synthetic estradiol. Such data supports not the use of synthetic estradiol or aromatase inhibitors in aging women, but the need to maintain a healthy balance of physiological normal levels of steroid hormones, using proven bioidentical hormone estriol and progesterone-stimulating creams, as well as the bioidentical precursor pregnenelone, developed and proven by Dr. John Lee and David Zava in the 1980s. The stubborn insistence on referring to the balance of estrogens and estrogen receptor types in the human body as simply one entity, estrogen, is amazing, yet this still dominates the field. Many approaches in Complementary and Integrative Medicine (CM/TCM) would greatly contribute to decreased cancer risk with aging, yet almost all are stubbornly resisted and ignored.


Developing new strategies to avoid unnecessary harm and insure better long term outcomes in patients diagnosed with in-situ benign but potentially precancerous breast lesions

Public health authorities across the world are worried about the unnecessary treatment and the stress generated, both physical and mental, engendered by the use of mammography to identify benign in-situ lesions and imply that these lesions are indeed cancer. The term ductal carcinoma in-situ (DCIS) is used to identify very small tissue lesions, usually calcified tissue, that could potentially become cancer. In-situ is a term that means confined to a site, or localized, and ductal refers to the tissues of the breast ducts, rather than the lobules, and is significant because these ductal tissues are more effected by local hormonal stimulation.

A majority of the tissue lesions detected by mammography are so-called ductal carcinoma in-situ. This means that there are small tissue lesions that are not spreading in the breast, with no evidence that they are growing, or that these tissue lesions will not be cleared by normal immune responses. Scientific study has also been very critical of the way that risk has been assigned to these DCIS lesions. If analysts rely on an assumption from some small studies that the prevalence in 40 to 50 year old women of DCIS is 9 percent, then the highest statistical possibility of cancer mortality, applying general statistics of the population as a whole, is 33 percent, which is high, but represents only the worst case scenario. Now, if the researchers rely on data from other small studies that show that the prevalence of DCIS in 40 to 50 year old women is 40 percent, which is more likely, then the risk of eventual cancer mortality at its worst is 7.5 percent, compared to 3 percent for the general population. Researchers note that this is the worst case scenario statistically, and the actual risk is likely much lower. These statistics can be used to create unnecessary alarm, and there is fear that DCIS statistics have been used to both create more business and to improve statistical outcomes, as these outcomes for patients with metastatic breast cancer were not improving, and adding cases of benign cancers greatly improves the outcome statistics overall. Many public health experts have concluded that this is the case, given that 40 percent of the women diagnosed with DCIS have opted for a double radical mastectomy, despite no proof of benefit over lumpectomy and excision of only one lymph node as a precaution. In 2013, a meta-review of such studies of breast cancer outcomes, by experts at the University of British Columbia and the British Columbia Cancer Society, in Vancouver, BC, Canada, found that there were no definitive studies published comparing outcomes for radical mastectomy in young women with breast-conserving therapy, despite the obvious need of this evidence to make informed decisions! All of the small randomized controlled trials and cohort analysis have concluded that there is no statistical benefit for radical mastectomy in women with breast cancer under the age of 40, but even in 2013, there have been no large studies to definitively show patients that this is true (Curr Oncol 2013 Dec; 20(6): e593-e601). The recommendation for 40 percent of these women to opt for radical mastectomy is based on opinion. Obviously, there is a need for more refined screening.

A large scale study in Europe, The European Organisation for Research and Treatment of Cancer (EORTC) completed a large randomized trial of women diagnosed with DCIS and found that with excision and targeted radiation, the rate of recurrence of invasive lesions after 10.5 years was 8%. The rate of incidence of breast cancer in the general population in this age group is about 3%. It should be noted that most cases of DCIS assessed with biopsy do not find invasive cancer. Numerous studies now show that there is no statistical difference in outcomes of invasive breast cancer treated with mastectomy and breast-sparing therapy (BCT) such as lumpectomy and excision of only the affected lymph nodes. These statistics represent long-term recurrence of treatable cancers with this protocol. This incidence of recurrence could be further reduced as each year more research reveals a variety of ways that herbal and nutrient medicine could decrease the risks of recurrence. While all of the data on breast cancer pathology and risk is growing more complicated, which naturally generates much stress and worry in the patients diagnosed with DCIS, the actual outcomes with monitoring, standard protocol, and integration of Complementary Medicine, appear to be reassuring. One problem that is increasingly discussed, is that as screening techniques advance, a growing percentage of women after age 40 are found to have these very small calcified lesions. It is now believed by many experts that small calcifications are ordinary findings in a majority of women if we look more thoroughly. As cited, cadaver studies in recent years have found these lesions in multiple sites of the breast milk ducts and lobules in greater than 40% of bodies (see the report cited below). The failure of modern medicine has been the failure to create an assurance that a comprehensive strategy will provide the women diagnosed with precancerous lesions a safe future. Instead of the current atmosphere of fear and dread, better communication and patient education should be adopted to achieve a real understanding that improved standard protocols with Integrative approaches utilizing Complementary Medicine will allow the woman diagnosed with breast cancer to proceed in life with peace of mind.

As stated, at present, the typical treatment suggested with findings of ductal carcinoma in-situ is surgical removal of the tissue and targeted radiation, with or without the use of tamoxifen, as a precautionary strategy. Because this course is now questioned heavily by many experts, a call for improved histology and separation of benign and potential lesions is needed. Further studies, such as the Van Nuys Prognostic Index, have completed large retrospective analyses, and found that by utilizing improved histological classification, analyzing lesion size and morphological classification, that a subset of patients that had received excision alone, without radiation or tamoxifen, had a recurrence rate of lesions of only 2% after 79 months (6.5 years).

Another option for these patients where a cancer potential has been noted, but not actually cancer, is to monitor and adopt an aggressive strategy with Complementary Medicine to aid the body in prevention of the cancer mutations. Improved histology would allow the women to decide with confidence that this approach is safe. Much research has gone into this strategy. We now know the mechanisms that drive cancer mutations, and each year the research finds more information, and then finds more and more ways that the person can utilize to stop the possibility of increased cancerous mutation and growth. Hormonal imbalances, inflammatory processes, accumulation of free radical oxidants, accumulation of heavy metal toxins, and other concerns can be addressed with a proper course of safe and effective therapy and lifestyle change as the tissue is monitored. This is the current advice from some of the most respected cancer experts in the United States. This is a more complicated approach than radical mastectomy, but is the sensible and safe approach. Hormonal balance can be assessed and restored with bioidentical hormonal therapy, and a variety of antioxidants, aromatase inhibitors such as DIM and specific herbal formulas, and cancer protectants that are proven in studies, may be taken as the tissue is monitored for threatening changes. In the long run, this type of therapy is healthful and provides not only a potential protection against cancer mutations, both in the breast and other tissues in the body, but potentially increases one's health in other regards.

The study of potential lesions in breast cancer has revealed that there is a relation between the estrogen receptor (ER) and insulin-like growth factor-I (IGF-I) receptor expression in specimens that seem to have the potential to become malignant. Metabolic syndrome seems to play an active role in this type of cancer development, as abdominal obesity in women is associated with higher concentrations of both free estradiol and free IGF-I. Higher concentrations of these hormones may result in hormonal imbalances that drives the estrogen receptor imbalance of alpha and beta, although conversion and creation of hormones in the localized tissue via aromatization is considered the prime driver of the cancer growth once the estrogen receptor imbalance is created. Improved screening and education of the patient with metabolic syndrome, noting levels of free IGF-I, may be part of a more comprehensive screening strategy that is tailored to the individual. Metabolic syndrome may be reviewed on a separate article on this website, and a comprehensive holistic individually tailore treatment strategy is recommended. This is one of the related imbalances in the body that applies to a subset of the women diagnosed with precancerous lesions, and is now creating more ways to create less risk.

Besides treatment to counter metabolic syndrome, which must be approached with a holistic treatment protocol because of its systemic nature and problems in a number of physiological systems in the body, addressing hormonal imbalances, and treating the problems related to the three most important biomarkers in breast cancer evaluation of potentially precancerous in situ lesions, COX-2, p16 and Ki67, are promising ways to utilize Complementary Medicine in an integrated fashion with standard oncology to decrease the risk of developing breast cancer. A number of Chinese medicinal herbs are proven to inhibit or modulate the COX-2 expression, especially those used in the adjunct treatment in cancer. Examples of these herbs studied in the United States, with studies available on the NIH database PbMed.gov, include Trypterygium Wilfordii, Scutellaria baicalensis, Carthamus tinctorius, and Curcuma zedoaria. Milder COX-2 inhibition can be achieved with foods. The USDA database, Dr. Duke's Phytochemical and Ethnobotanical Databases, lists a number of common foods that are found to inhibit cyclooxygenase activity, including tea, thyme, oregano, spearmint, rosemary, sage, bilberry leaf, blueberry, onion, and the common herbs Gingko biloba, Yarrow, Licorice root, and Motherwort (the Chinese herb is called Yi mu cao). Increasingly, new studies are finding herbal chemicals that affect the p16 and Ki67 pathways also. A 2010 study in China found that the herbal chemical epigallocatechin-3-galate in tea could effect demethylation of P16 and inhibit growth of leukemia cells in vitro. A quality green tea, such as Dragonwell, or Long Jing, is recommended, but a variety of quality natural teas, all made from camellia, are effective, and stronger green tea extracts are readily available. A 2002 study at Shanghai medical universities found that a common Chinese tonic formula, Si Jun Zi Tang, significantly reduced stomach cancer cell growth by promoting normal cell apoptosis, or programmed cell death, and affected the Ki67 pathway. As research advances we are finding more and more evidence of benefit from common therapeutic protocols in Traditional Chinese Medicine. Adoption of such dietary regimes and herbal therapy could either aid prevention or treatment of cancer greatly , and is supported by sound research. Refer to the article on this website entitled Cancer Adjunct Therapies Improving the Quality of Life for more information and links to these studies.


Screening for Stomach Cancers

Gastric cancers are still an important concern in 2015, worldwide, but especially in developed countries with contributing environmental and dietary contributors. The poor survival rate in gastric cancers is due mainly to advanced stage diagnosis, and so better markers of disease and differentiation need to be found. At present, oncologists are utilizing frequent endoscopy and endoscopic resection to find and cure stomach cancers at an early stage, with moderate success. Unfortunately, this often results in an overuse of these endoscopies that may prove to cause more harm than benefit in the future, much like the screening practices in breast and prostate cancer did. The need for well-designed biomarkers with systematic validation of treatment steps is sorely needed and being researched. Until then, many patients with findings of abnormal tissues that are not cancerous will unfortunately undergo yearly endoscopies as a preventive measure that may cause mucosal damage that could itself lead to stomach or intestinal cancer. An article in the October 25, 2010 New York Times Research Section reported that while endoscopies are generally reported to be safe, that a large study at Beth Israel Deaconess Medical Center in Boston tracked the post-endoscopy history of over 18,000 patients and found that about 1 percent of these procedures resulted in a visit to the emergency room within 2 weeks due to complications, with 76 hospitalizations. While one percent may be acceptable to medical doctors, this is an alarming figure if endoscopy is recommended yearly for screening in stomach cancer. Hopefully, we will soon have a safer and healthier way to screen for potential stomach cancers. A 2012 study at the University of Rome Sapienza, and Nuovo Regina Margherita Hospital, in Rome, Italy, recommended that yearly endoscopy may be advisable when one of four findings are apparent: 1) intestinal metaplasia (IM) extension greater than 20 percent, 2) the presence of incomplete types of IM, 3) a first-degree relative with stomach cancer, or 4) significant cigarette smoking history. This study showed that 1 in 4 patients undergoing endoscopy shows a finding of some IM, but not enough to justify the risks and adverse consequences of yearly endoscopy.


Screening for Lung Cancers

Today, in the United States, lung cancer screening utilizes yearly CT scans for patients over age 55 at risk for this most deadly variety of cancers. Mandated screening with low-dose CT scans was recommended by the United States Preventive Services Task Force, a volunteer and independent group of physicians, and thus became a mandated standard for screening in the insurance industry. In 2014, the actual government panel from the Medicare advisory committee voted that there was too much potential harm and not enough benefit to approve this yearly CT scans for heavy smokers, though. A May 12, 2015 New York Times article, entitled Assessing the Value of Lung Cancer Screening, evaluated some of the controversial data concerning use of CT scans to detect some of these lung cancers, but what was most revealing was what was omitted in this discussion, namely the threat of accumulative radiation from CT scans increasing the future risk of lung cancer past the 5 year study window that supported the CT scan screening. A persistent denial of accumulative radiation from medical devices such as the CT continues to frame the assessment, despite the warnings of the last President's Council on Cancer report that framed medical radiation as a rising concern in the array of factors that cause cancer.

More than 10 million Americans will be eligible for lung cancer screening with CT scans under the new guidelines, and there are mandates restricting insurance charges for such preventive screening, but the question of risk versus benefit of such screening with high accumulative radiation is concern. Not only the individual past exposure to accumulative radiation, but the stress of follow-up testing after positive findings with CT scans is an issue. A high percentage of these positive findings in lung CT scanning will be false positives, and subsequent follow-up will involve biopsies, exploratory resections, or worse, unnecessary cancer treatment. CT scans cannot distinguish between small nodules or lesions that are benign, and those that may become lethal, with metastasis. In the U.S. national trial that led to these new lung cancer screening guidelines, almost 40 percent of participants over the age of 55 with a history of heavy cigarette smoking received a positive finding on the yearly CT screenings, yet 96 percent of these detected nodules or lesions were not cancerous. With the false positives, additional CT scans were recommended, increasing accumulative radiation. The stress and anxiety generated by these many false positives also had negative health consequences, sometimes quite devastating. Lung biopsies come with considerable risk, with 20-25 percent resulting in a pneumothorax, or collapsed lung. Older participants in these screening trials showed higher rates of cancer, but more false positives as well. Often, the medical doctor may recommend a wedge resection surgical procedure when a positive CT screening occurs, and this procedure comes with considerable pain and discomfort, sometimes for months. While the lung cancer screening trials showed an advantage over X-ray screening of 20 percent, which sounds impressive statistically, when seen relative to the number of actual lives saved, the benefits may not outweigh the risks. With X-ray screening for older patients at high risk, 1.7 percent of participants had a potential for dying of lung cancer in the next 6.5 years, while with CT screening, with much higher accumulative radiation, 1.4 percent of participants potentially could have died of lung cancer over this time period. The real question for the individual patient, especially considering the overall failure statistically in risk versus benefit assessments in the past of the X-ray screening, is whether this CT screening is really worth it. The CT screening is found beneficial only in relation to the X-ray screening, and then only with mild actual benefits, and greatly increased risks.

For the individual that is worried about lung cancer, which is a real worry, considering that it is still one of the deadliest of cancers, with only a small percentage surviving 5 years after diagnosis, the question of whether other types of screening and prevention are desirable is an important question. Newer technology has produced imaging with MRI that is specialized and without any radiation, yet is not adopted in standard medicine, seemingly because the CT scans are already in place, and thus more profitable. In addition, the continued mantra that this CT scan screening is all that is necessary for patients at high risk of lung cancer as they age is shortsighted and ridiculous. There is much that the patient can integrate into their preventive strategy, and utilizing Complementary and Integrative Medicine (CIM) to decrease the risk of future lung cancer seems sensible and inexpensive, and comes with no adverse side effects. Integration of Complementary Medicine would also help relieve the stress of the cancer testing and findings, potentially help clear the adverse health effects of accumulative radiation, and engage the patient in a more proactive strategy, even if yearly CT screening is chosen. Even when CT screening produces a real positive finding, and follow-up does determine that an early stage lung cancer exists, the current treatment involves surgical removal of a lobe of the lung, or lobectomy, and in the national trial this came with a mortality risk of 1 percent, and often did not stop the cancer from recurring in the future. As these screenings and lobectomies occur more often, many will occur in hospitals that are not the state of the art hospitals involved in this national trial, and experts expect a mortality rate in older patients undergoing lobectomy of up to 4 percent. The last factor for the individual to consider is related to age. This national trial did not provide information on patients older than 77, yet we can expect a large percentage of patients getting this CT screening to be over this age. It is common for such medical trials to use optimal settings and care, and target an optimal study population, but when the findings are applied as guidelines, go outside of the trial study parameters.


Do Medical Doctors actually support Complementary and Integrative Medicine (CIM) in the overall treatment plan with cancer prevention and care?

Dr. Ka-Kit Hui, Dr. Edward K. Hui, MDs, and Michael Francis Johnston, PhD, from UCLA Center for East-west Medicine wrote in Integrative Cancer Therapies, Vol. 5, No. 1, 56-62 (2006): The Potential of a Person-Centered Approach in Caring for Patients with Cancer: A Perspective from UCLA Center for East-West Medicine: "Evolving patient preferences as well as an expanding evidence base for commonly used complementary and alternative medicine therapies for patient with cancer have led to inroads by integrative medicine into clinical oncology. Traditional Chinese Medicine (TCM) has been used in conjunction with conventional biomedicine in the prevention and treatment of cancer in China for several decades. Methods: the authors, through select review of the existing literature and by drawing on clinical experience, describe a person-centered approach to care of patients with cancer that incorporates TCM concepts and techniques. Two cases are used to illustrate how this approach might address unmet needs and enhance quality of life for patients with cancer. Results: TCM's emphasis on a comprehensive understanding of imbalance in various systems and resultant compromise of homeostatic reserve as well as its ability to treat them with distinctive therapeutic modalities can add unique value to the overall management of the patient with cancer. Conclusions: TCM can be used adjunctively to improve quality of life and functional status during a patient's struggle with cancer. An approach integrating both medicines that is guided by scientific evidence, safety, and patient preferences has the potential to improve modern oncologic care."

History in the West: A long history of medical doctors in Europe has established a firm naturopathic foundation of research and theory in the use of Complementary Medicine in cancer therapy:

The foundation of complementary medical therapies in European cancer protocol rests with the German doctor Max Gershon. Dr. Gershon examined the mechanisms of cell mutation and came up with a comprehensive list of therapies. Alone, these therapies may not be enough to significantly reverse the cancerous mutations, but together, the package of therapies has been shown to be very helpful. Many patients with this approach have gone into cancer remission and survived long term. Cancer Therapy: The Results of Fifty Cases is Dr. Gershon's classic book. Other books available include: The Topic of Cancer, Cancer: A New Breakthrough by Virginia Livingston, author of a number of books. Dr. Gershon utilized diet high in potassium with raw food juices, oxygen therapies, and a variety of techniques combined in naturopathic clinics and hospitals devoted to treatment of the cancer patient.

Unfortunately, or fortunately, depending on your perspective, the subject of Complementary Medicine as adjunct therapy in cancer protocol cannot be covered in a webpage. The research and history of treatment is enormous. What I can present to you on this page is a sample of the subject, and is not representative of the total treatment resources available. The key to effective treatment protocol is the knowledge of your physicians, your choices, and the effective management of the protocol. Not everything that is researched can be utilized at once, and the choice of which protocols to use during which phase of your treatment and recovery is extremely important.

Anticancer nutrient chemicals found in foods and herbs

There are a growing number of unbiased and non-commercial databases that provide the scientific study data available on nutrient chemistry that the patient with increased cancer risk may explore to build a comprehensive strategy to clear cancer risk. The USDA, or Unite States Department of Agriculture, maintains a number of databases, including Dr. Duke's Phytochemical and Ethnobotanical Databases, PubMed, and the growing AHRQ (Agency for Healthcare Research and Quality). While the nutrient chemicals found in foods may not be of significantly high dosage, including these foods in the daily diet provides a steady low dosage that is helpful, and more concentrated dosage is found in medicinal herb extracts and standardized supplements. Utilizing these standard databases, I am able to present a portion of the pertinent data on anticancer nutrients in food and herbs below to help guide dietary and herbal cancer preventive protocols:

Anticancer nutrients related to stomach cancers include sulfur containing carbohydrates such as allyl methyl-di- and trisulfides, found in shallots, onions, and garlic, especially in fresh onions and garlic, which also contain diallyl sulfide, a proven anticancer nutrient chemical. These chemicals don't just cause bad breath, but are integral to the body's ability to detoxify our cells. Another sulfide with anticancer activity is diallyl-sulfide, found in asa-foetida and watercress, as well as shallots and garlic. This family of sulfides includes the sulfur amino acid cystine, which is integral to the glutathione metabolism, and to health of the intestinal membranes. The supplement N-acetyl-cysteine is an important related nutrient medicine useful in clinical therapy. Nutrient chemicals found to have anticancer properties related to pancreatic cancer include monolaurin, found in saw palmetto fruit, which is also famous for its use in reducing prostate cancer risk, and contains the anticancer nutrients monomyristin and geraniol also. Unprocessed coconut oil is converted in the human body to monolaurin as well. The anticancer phytohormonal chemicals farnesol and geraniol are found in the garden herbs oregano, thyme, rosemary and ginger root, the herbs cumin, coriander, cardamon and cinnamon, as well as the Chinese herbs, cinnamon bark, frankincense resin, bitter orange peel, black walnut shell extract, crepe myrtle, salvia, vitex, and gotu kola. Teas also include these chemicals, such as the common chamelias, and the herbal teas with spearmint and chamomile. Perillyl-alcohol is a nutrient found in perilla, used as a fresh leaf in Japanese sushi, and found as a dried Chinese herb, and in spearmint, bay leaf, chamomile, and caraway seed.

Diallyl-sulfide is also found to have anticancer properties related to colon cancer, so daily intake of shallots and garlic is an important dietary habit. The nutrient S-allyl-L-cysteine is also an anticancer nutrient found in shallots and relate to the supplement N-Acetyl-Cysteine, already mentioned. Chlorophyll is also an anticancer nutrient related to colon cancer, and fresh organic greens, such as collard and mustard greens, are especially beneficial. Chlorogenic acid is another of these nutrients, and is an important intermediate in the formation of the supernutrients lignins and lignans. Lignins are complex chemicals found in algae and woody herbs, and lignans are phytoestrogens and antioxidants that are proving especially beneficial in cancer prevention and hormonal health. Potent lignans, such as the extract from Norway Spruce patented as NuLignan, have passed human clinical trials in Finland and found to significantly increase the breast cancer preventative enterolactones. Dietary intake of lignans and maintained circulating levels of enterolactone have been found to decrease breast cancer risk in double-blinded placebo studies in a number of countries now. Chlorogenic aci, and intermediate in this metabolism, is found in shallots and garlic, as well as green tea, paprika, cayenne, coriander, flaxseed, walnuts, apples, blueberries, thyme and oregano. A number of Chinese herbs contain Chlorogenic acid, including Astragalus, Siberian ginseng, Salvia, Japanese honeysuckle, Berberis, white mulberry bark, marshmallow root, artemisia absinthia, Vitex, Ashwagandha, and the North American herbs St. Johnswort, Valerian, bilberry, nettle, yarrow, angelica archangelica, arnica, echinacea, goldenseal, lemonbalm, and comfrey. Maintaining the health of the intestines, healthy flora and fauna with effective probiotics, and consumption of lignans and chlorogenic acid is a prescription for decreased risk of colon cancer. Other nutrient chemicals proven useful include ursolic acid, ferulic acid, and ellagic acid, found in rosemary, thyme, oregano, lemons, oranges, plums, strawberries and barleygrass, as well as a wide variety of Chinese herbs.

Legumes have long been a healthy staple worldwide and recent studies have shown that a higher consumption of legumes is associated with a lower incidence of colorectal cancers. Sulfured amino acids, fiber and various nutrient compounds in beans, lentils, chickpeas and soybeans have been found to be effective in both prevention and treatment of early stage cancers, especially colon cancer. Chlorophyllin, a derivative of chlorophyll in green plants, has also been proven as a cancer preventive, modulating cancer signaling pathways such as NFK-beta, Wnt/beta-catenin, and phosphatidylinositol-3-kinase/Akt signaling, as well as the Transforming Growth Factor beta (TGF-beta) pathway that speeds cancer metastasis. A diet rich in legumes and green vegetables, healthy oils, and fresh fruit is proven to be a strong cancer preventive protocol.

Added to the dietary protocol in cancer prevention should be periodic treatments with Complementary and Integrative Medicine, the best form of systematized preventive medicine available. Therapy with professional Chinese herbal formulas is not only helpful to treat specific problems, but often contains a variety of beneficial nutrient medicinals that are found to have anticancer properties and contribute to a healthy preventative cancer routine. Unlike pharmaceuticals, these herbal formulas have a wide variety of natural chemicals evolved in nature that help the organisms correct cell mutations and modulate inflammatory mechanisms that cause cancer. Treatment with Complementary Medicine is thus a smart move in general for patients with increased cancer risk showing up in future screening protocols, as well as the rest of us, since some form of cancer is likely to occur in almost every body as it ages. Specific anti-cancer and cancer preventive chemicals in Chinese herbs are now standardized for better utilization within a broader treatment protocol. Quercetin, resveratrol, curcumin, and berberine all are evidence-based herbal and nutrient chemicals useful in prevention of cancer. Short courses of acupuncture and physiotherapy with repeated short courses of these cancer preventive herbal and nutrient medicine formulas will provide amazing benefits, perhaps not immediately felt, but with evidence proving the long-term benefits. Waiting until cancer occurs is not a good plan.

Breast and prostate cancers, which account for a great percentage of cancer deaths each year, are also aided by a number of anticancer nutrients. These include the lycopenes, already mentioned, and phytohormonal nutrients such as beta-sitosterol, catechol, and genistein, which are combined with zinc in a supplement to benefit prostate health. Genistein is one of several potent isoflavones, or flavonoids, found in fava beans, soybeans, and various herbs, including kudzu, psoralea, and Mucuana pruriens. Beta-sitosterol is found in fennel seed, basil, soybean, corn, buckwheat, and the herbs saw palmetto, white mulberry, Salvia, and Ashwagandha. Lutein, a yellow orange pigment in the carotenoid family, such as beta-carotene (carrots, sweet potatoes, cantaloupes, oranges, tangerines), is also a beneficial nutrient chemical with anticancer effects. Lutein is found in green leafy vegetables, such as collard greens, spinach and kale, as well as in egg yolks, and in the herb bilberry, with luteins from this fruit and other herbs commonly used to treat or prevent macular degeneration of the eye as well. Once again, a healthy diet of these fresh foods that are increasingly popular and found in local healthy groceries, as well as periodic treatment with herbal formulas provides a proven and healthy regimen to decrease cancer risk and prevent the worst cancers as you age.

Besides this wide array of herbal and nutrient chemicals that may be incorporated into your diet and daily life, there is increasing evidence of amazing cancer prevention from herbal nutrient medicines that are prescribed professionally. Many of these products are advertised and sold in retail stores in the United States, but without FDA regulation of this industry, numerous studies have shown that up to 80 percent of herbal and nutrient products bought off the shelf randomly do not have the ingredient, dosage or correct type of herbal and nutrient chemicals listed on the label. This is because there is no legal penalty for such misbehavior in the industry. Professional herbal and nutrient medical companies, on the other hand, insure that their products are what they say they are and are of high quality, and they sell these products only through professional physicians to insure that no harm is committed by self-diagnosis and prescription. You may go to the article on cancer on this website to see the amazing array of research proving the efficacy of these herbal and nutrient products. Simple nutrient supplements that are now commonly prescribed to prevent breast, ovarian, endometrial and prostate cancers include ProDIM, NuLignan, D-Chiro inositol, LongVida (enhanced curcumin), resveratrol, and gamma-tocotrienol.

No matter who you are, or how healthy you perceive yourself, as you age you must be aware of the fact that the human body experiences cell mutations, that the environment poses many challenges to your health, and that you can't afford to wait until you are diagnosed with cancer to do something about this health concern. We make choices on a daily basis that may contribute to your future health, and adopting a well informed and intelligent diet and lifestyle is just as important as any decisions you might make. If you want to be successful, look good, be happy, you must stay healthy, and utilizing the information and resources inherent in Complementary and Integrative Medicine is a way for you to utilize individualized cancer screening data and take a proactive approach to preventing cancer.


Information Resources and Additional Information with Links to Studies

NOTE: Two more articles on cancer are available on this website, each with many links to published scientific studies that are important in the treatment and prevention of cancer, and for more scientific proof you should go to these articles and Additional Information sections as well. As you see, the number of sound scientific studies supporting CIM/TCM in adjunct cancer care is very large now and growing, and should reassure patients that such integration of TCM therapies is going to help dramatically to achieve the best outcome, or more importantly, to prevent the occurrence of cancer.

  1. An Op-ed in the New York Times in March of 2010 by the creator of the PSA screening technique, Dr. Richard Ablin, was written to speed up the changes needed in prostate cancer screening, and to quit using PSA as the prime marker for the cancer detection: http://www.nytimes.com/2010/03/10/opinion/10Ablin.html
  2. A New England Journal of Medicine article in March of 2009 outlined the findings of the large long-term United States study of prostate cancer screening that showed no reduction in mortality from use of the PSA screening: http://content.nejm.org/cgi/content/full/NEJMoa0810696
  3. A New England Journal of Medicine article in March of 2009 outlined the findings of the large long-term European study of prostate cancer screening that showed no reduction in mortality from use of the PSA screening: http://content.nejm.org/cgi/content/full/NEJMoa0810084
  4. A New England Journal of Medicine article in November of 2014 outlined the data that showed that aggressive cancer screening, especially in South Korea, has resulted in an increase of up to 15 times the diagnoses of thyroid cancer seen in 1993, yet this enormous increase in diagnosis and aggressive treatment did not reduce thyroid cancer mortality at all, suggesting that the real problem is overdiagnosis attributed to widespread standard screening. What is overlooked in these assessments is the fact that screening should define the degree of risk and instead of alarming patients should provide them with a realistic and comprehensive plan to improve prevention of future metastatic cancers with safe and effective Complementary Medicine, not aggressive and harsh therapies designed for metastatic cancers that are not yet evident. For a full assessment of this study, go to the New York Times article of November 6, 2014, entitled Study Points to Overdiagnosis of Thyroid Cancer: http://www.nejm.org/doi/full/10.1056/NEJMp1409841
  5. The NIH (National Institutes of Health) released an official recommendation outline of the National Cancer Institute in March of 2009 concerning prostate cancer screening and statistical data, and concluded that annual screening had not proven beneficial in reducing prostate cancer mortality: http://www.nih.gov/news/health/mar2009/nci-18.htm
  6. A 2009 meta-analysis update of studies concerning breast cancer screening with mammography concluded that it was still unclear whether screening does more harm than good, and that it was still only likely, not certain, that mammography screening to date has reduced breast cancer mortality at all: http://www.be-md.ncbi.nlm.nih.gov/pubmed/19821284
  7. A 2013 study published in the Journal of the National Cancer Institute found that for women over the age of 40, that mammograms every 2 years did not differ statistically in risk of breast cancer mortality than yearly mammograms, and did create significantly increased rates of false positive findings, which generate much stress and fear: http://jnci.oxfordjournals.org/content/early/2013/02/01/
  8. A 2014 25-year follow-up study of breast cancer incidence and mortality, published in the esteemed British Medical Journal, found that there was no statistically significant difference between survival rate of women diagnosed with invasive breast cancer after mammography and controls in a randomized trial. The conclusion of experts from the University of Toronto was that annual mammography in women aged 40-59 did not reduce mortality from breast cancer over that of physical exam and usual care: http://www.medscape.com/viewarticle/820822
  9. A 2015 set of guidelines for breast cancer screening by the U.S. Preventive Services Task Force, finally agreed to by the American Cancer Society, recommended that biannual (every 2 years) mammography be limited to women age 50-74 and take into consideration finally patient context and values regarding benefits and harm from radiation screening. The task force concluded that teaching women self exam for breast screening should also be curtailed, as this has resulted in much stress, fear and anxiety without producing positive results in detection of actual metastatic cancer. The task force is still reviewing evidence for use of advanced MRI to screen for early cancer: http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/breast-cancer-screening
  10. A 2014 study at the Ludwig-Maximillians University and Heirnrich-Heine University Schools of Medicine, in Germany, found that MRI screening was a well-established method for monitoring metastatic breast cancer after treatment, and that the addition of monitoring circulating tumor cells (CTCs) as a marker for metastasis was a significant predictive test, but did not result in improved survival. These experts recommended that the use of CTC detection be limited to select cases: http://www.ncbi.nlm.nih.gov/pubmed/24803882
  11. A Washington Post article in 2008 outlined the findings from a study by the Dana-Furber Cancer Institute and Brigham and Women's Hospital in Boston, that showed that less than 1 percent of precancerous breast lesions detected will advance to a metastatic breast cancer, and that only a few percent of metastatic breast cancers are now untreatable: http://www.washingtonpost.com/wp-dyn/content/article/2008/02/12/AR2008021201809.html
  12. A 2012 study at the University of Florida College of Medicine, in Jacksonville, Florida, U.S.A. reviewed thousands of breast biopsy results and determined that on a cellular level that there is no real difference between atypical ductal hyperplasia, which will not develop into cancer in almost all cases, and samples designated as ductal carcinoma in situ (not spreading, or localized). Biomarker studies and testing of molecular genetics have shown no difference between these benign and "potentially cancerous" breast lesions. These researchers suggest that the explosive growth in diagnosis and treatment of breast cancer involving breast lesions labeled "ductal carcinoma in situ" has no real scientific basis: http://www.ncbi.nlm.nih.gov/pubmed/22171775
  13. Liquid Biopsy, or analysis of DNA fragments in blood, is being rapidly developed as another excellent tool for early non-invasive analysis of cancer type and progression to guide therapy. A 2016 presentation by the University of California Davis Comprehensive Cancer Care Center showed that in a study of 1500 samples, where 400 were matched to actual tissue biopsies, that 94-100 percent matched the tissue results. This type of test is non-invasive and adds to data to better determine the best integrated course of care and avoid unnecessary harsh therapies when possible. Here, a 2015 explanation from experts at the Catalan Institute of Oncology in Spain, and the Cancer Therapeutic Intervention Group in New York explains this science:http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4356857/
  14. A 2011 study at the Charite University School of Medicine, in Berlin, Germany, found that fast 3D Near-Infrared imaging using a contrast indocyanine green successfully detected early stage breast cancer lesions and distinguished between benign and metastatic lesions: http://www.ncbi.nlm.nih.gov/pubmed/21972043
  15. A 2014 study at the Libre University School of Medicine, Erasme Hospital, in Brussells, Belgium, found that use of a breast MRI in screening did not increase the percentage of screened women undergoing mastectomy, like X-Ray or CT scan screens, and successfully screened potentially metastatic breast lesions, with a follow-up ultrasound and/or biopsy used to differentiate the morphology and risk. By substituting MRI for standard X-Ray and CT the use of neoadjuvant chemotherapy (targeted chemotherapy to shrink a tumor before primary therapy, such as lumpectomy) was used more often, and the percentage of reoperations was decreased: http://www.ncbi.nlm.nih.gov/pubmed/24864145
  16. A 2014 study at the Oncology Centers in Bydgoszcz and Gilwice, in Poland, found that combining dynamic and morphologic MRI breast cancer screening methods increased the sensitivity to differentiate breast cancers successfully. The standard method of screening, involving X-Ray mammograms, was criticized for its low sensitivity: http://www.ncbi.nlm.nih.gov/pubmed/24847391
  17. A June 7, 2010 article in the New York Times outlines the findings of new European long term studies that show that a minimal protocol of lumpectomy with a single focal radiation treatment and removal of just the cardinal lymph node produces the same or slightly better outcome than the more radical surgical and radiation approaches currently recommended for early stage breast cancer and precancerous lesions called ductal carcinoma in situ: http://www.nytimes.com/2010/06/08/health/08canc.html
  18. An article published in JAMA in September of 2009 and outlined in the New York Times in October summarizes scientific findings that we now know that many cancers slow, stop or reverse into remission without standard therapy, the key being how to enhance this natural process with Complementary Medicine: http://www.nytimes.com/2009/10/27/health/27canc.html
  19. A March, 2010 article in the New York Times Health section reveals that more and more women are opting to remove both breasts when precancerous lesions are detected because of a lack of clear patient education and a strong fear of cancer: http://query.nytimes.com/gst/fullpage.html?res=9C02EFDD1239F93AA35750C0A9669D8B63&sec=&spon=&pagewanted=1
  20. A history of the aggressive blunders in breast cancer screening and why radical mastectomies did not reduce cancer deaths was published in the Annals of Internal Medicine in 1998 (vol.129): http://www.annals.org/content/129/1/74.full
  21. A 1997 analysis published in the Annals of Internal Medicine outlines how statistics are used to increase the risk assessment of so-called ductal carcinoma in-situ, and how this drives an overblown fear in the patient: http://www.annals.org/content/127/11/1023.full
  22. A July 20, 2010 article in the New York Times explains how precancerous lesions are very difficult to assess, and that many biopsies of 'so-called' ductal carcinoma in situ do not produce firm evidence of even a precancerous lesion, yet are still used to drive a protocol of mastectomy, lumpectomy, and other harsh therapies: http://www.annals.org/content/127/11/1023.full
  23. An April, 2010 article in the New York Times outlines the findings published online by the Journal of the National Cancer Institute, which finds that 3 biomarkers, p16, COX-2, and Ki67, are the most important in screening of in-situ precancerous lesions of the breast. When all 3 are positive, there is a 20 percent risk of developing invasive cancer in 8 years, while negative markers reduce risk to 4 percent, just one percentage point over that of the general population: http://www.nytimes.com/2010/07/20/health/20cancer.html
  24. Current treatment research from the NIH, National Cancer Institute, outlines the success with current minimal treatment strategies with precancerous lesions called ductal carcinoma in situ (DCIS). Progress in classification of these precancerous lesions has led to many women showing a recurrence rate of precancerous lesions after 6 years of 2 percent with excision only, when the lesion is classifed properly and found to be less threatening: http://www.cancer.gov/cancertopics/pdq/treatment/breast/HealthProfessional/page5#Section_81
  25. A 2012 call for improved classification of breast cancers to guide prognosis, by experts in Japan, printed in BioMed Central, outlines clear research-based guidelines of improved cytological classification that could decrease the fear of a bad prognosis for many women, and significantly improve treatment protocols. We see from this study that about a third of metastatic breast cancers are a Luminal A (ductal) type that is slowly growing and HER2 negative, usually low-grade, and that these can now be further divided histologically into DNA diploid or aneuploid types and either positive or negative for chromosomal instability to improve prognostics, or predictions of risk for the future. Such study is now being devised to both reassure patients and to reduce the harm from unnecessary harsh therapies. It could also be used to guide integration of more benign therapies from CM/TCM in adjunct care: http://bmcresnotes.biomedcentral.com/articles/10.1186/1756-0500-5-376
  26. An article in the New York Times, April 2010, follows women that have survived the worst type of breast cancer for decades: http://well.blogs.nytimes.com/2010/04/27/living-for-years-with-late-stage-cancer/
  27. A 2012 large case-control study in Greece showed that a healthy Mediterranean Diet, or a plant-based diet of fresh organic vegetables, fruits, whole grains, healthy oils and limited amounts of healthy fish and fowl, prevents the recurrence of breast cancer dramatically. A follow-up study printed in 2016 by experts from the Placenza Hospital in Italy followed over 300 women diagnosed and treated for early stage breast cancer, and in a randomized controlled human clinical study, found that while 11 of the women who ate a normal diet had a recurrence of breast cancer, none of the women eating this Mediterranean Diet had a recurrence: http://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-12-113
  28. An article in the New York Times, July 15, 2010, reveals that the Obama Health Care Reform will include a mandate that eliminates patient fees for many types of cancer screening, certain routine laboratory tests, and some types of preventative medicine: http://www.nytimes.com/2010/07/15/health/policy/15health.htm
  29. Johns Hopkins University Kimmel Cancer Center reports on a new emphasis in cancer screening called PARE (Personalized Analysis of Rearranged Ends) that looks at rearrangement of blocks of the genetic code instead of specific oncogenes, which have not yielded results. The new technology should replace CT scans that have a large accumulative radiation risk, and with popular demand should drop in price to under 5000 dollars. These tests are conducted after blood tests identify biomarkers of disease to allow the testing lab to focus on blocks of rearranged genetic code to better guide individualized cancer therapies: http://www.hopkinscoloncancercenter.org
  30. A 2015 study of cervical cancer tissues to determine the real link between HPV (human papilloma virus) and cervical cancers, by experts in the Netherlands, China, Belgium and the United States (Weill Medical College of Cornell University), found that for a large percentage of cervical cancers, HPV is not found to be the cause of the cancer, and that between 20-40 percent of adenosqamous and usual types, especially in older women, that HPV is not driving the cancer growth. In many tissue samples, the HPV was found only in adjacent tissues, and just 3 types of HPV was found in over 90 percent of tumor testing positive, types 16, 18 and 45. In cervical cancers that involved clear cell tumor (that spread throughout the body) and endometrioid cancer cells, less than 10 percent were infected with HPV. Such study, finally performed, shows that the statistics assumed for decades and leading to calls for universal HPV vaccination, were untrue. We may only speculate on why this type of study was not done sooner: http://www.ncbi.nlm.nih.gov/pubmed/26334557
  31. An October 25, 2010 article in the New York Times reported that a large study following patients administered an endoscopy, the current screening method for stomach cancer, that about 1 percent went to the emergency room for complications within 2 weeks of the procedure, despite the widespread reporting that there are hardly any complications from this procedure. More than 18,000 patients records were tracked by experts at Beth Israel Deaconess Medical Center in Boston: http://www.nytimes.com/2010/10/26/health/research/26screening.html?_r=0
  32. A 2012 study at the University of Rome Sapienza and 2 hospitals in Rome, Italy, found that 1 in 4 patients undergoing endoscopy has a finding of some interstitial metaplasia, which could increase stomach cancer risk 6-fold, but the yearly endoscopies to screen for stomach cancer should be limited to subsets of patients meeting one of four requirements: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3312926/
  33. A review of scientific study of imbalance of the gut microbiota as a strong contributing factor in cancer pathogenesis, by the Euro-Mediterranean Institute of Science and Technology, in Palermo, Italy, found that dismicrobism, or biotic imbalance, is a strong contributor to inflammatory bowel disease, with increases the risk of colorectal cancer by 10-15 percent, and that such Biome imbalance is integral to immune problems and essential nutrient metabolism, particularly affecting the lymphatic immune system and growth factors, that could play a key role in the pathogenesis of a number of cancers: http://www.ncbi.nlm.nih.gov/pubmed/25561781
  34. In 2014, the U.S. FDA approved the first non-invasive self-administered screening test for colorectal cancer, called the ColoGuard stool test, which detects various biochemical markers that may indicate a higher risk for cell and tissue growths that could be precursors to cancer, or indicate the presence of cancer, especially at an early stage. This test is 84 percent effects in ruling out cancer, and can be used with a fecal immunochemical test (FIT), which is 94 percent effective in ruling out upper gi bleeding and cancer, and can be self-administered and read at home, allowing each patient to both seek real preventive medicine help and further exam and screening with a colonoscopy: http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm409021.htm
  35. Nonmelanoma skin cancer rates incidence is explosive in the United States after a decade of strict advice to avoid sun and always use sunscreen - many experts now feel that the strict sun avoidance and sunscreen use has led to a Vitamin D3 hormone deficiency that actually drives skin cancer: http://www.nytimes.com/2010/03/23/health/research/23patt.html?ref=health
  36. A 2012 meta-review of all published scientific studies concerning Metabolic Syndrome and cancer risk, by experts at the Second University of Naples, in Italy, found that there is a high association between Metabolic Syndrome and specific cancers, in men, increased risk with liver, colorectal and bladder cancers, and with women, increased risk for postmenopausal breast cancers, endometrial cancer, pancreatic cancer, and colorectal cancer. Treatment to reverse Metabolic Syndrome with CIM could prevent many of these cancers: http://www.ncbi.nlm.nih.gov/pubmed/23093685
  37. Evidence-based herbal medicine: Anticancer and antitumor effects of a common Chinese herb, Huang qin, or Scutellaria baicalensis, conducted in 2003 at the Mount Sinai School of Medicine in New York: http://cancerres.aacrjournals.org/cgi/content/abstract/63/14/4037
  38. Anticancer and antitumor effects of a common Chinese herb, Ulmus macrocarpa or davidiana, widely used in Korean herbal medicine: http://www.ncbi.nlm.nih.gov/pubmed/18378057
  39. Anticancer and antitumor effects of a common Chinese herb, Ban zhi lian, or Scutellaria barbata: http://www.ncbi.nlm.nih.gov/pubmed/14599863
  40. Anticancer and antitumor effects of a common Chinese herb, Yun Zhi, or Coriolus versicolor, commonly called turkeytail mushroom: http://www.ncbi.nlm.nih.gov/pubmed/15183073
  41. Further research into the activities that make the Chinese herb, Yun Zhi, or Coriolus versicolor, commonly called turkeytail mushroom, effective against breast cancer cells: http://www.ncbi.nlm.nih.gov/pubmed/15908782
  42. A 2011 study at the Medical University of South Carolina, Charleston, South Carolina, U.S.A. found that the Chinese herb Ganoderma lucidum (Ling zhi, or Reishi mushroom), when triterpenoids called Ganoderic Acids were extracted in alcohol tinctures, exerted significant apoptosis-inducing and immune modulating activities, making this herbal medicine a potential chemoimmunotherapeutic agent in standard medicine in the near future: http://www.ncbi.nlm.nih.gov/pubmed/23336088
  43. Research in 2013 at Southern Medical University, in Beijing, China found that the herbal polyphenol curcumin, found in a number of Chinese herbs, including Curcumin zedoaria, or E zhu, perhaps the most well-known anti-cancer herb in China, induces apoptosis in breast cancer cells by increasing caspase-3 activation, STAT3, and other antioxidant and cytokine pathways, thus making this herbal extract applicable to both estrogen receptor positive and negative cell lines: http://www.ncbi.nlm.nih.gov/pubmed/23545262
  44. Research in 2013, at the University of Louisiana at Monroe, found that the nutrient molecule gamma-tocotrienol, in the Vitamin E family, exerted significant effects of autophagy and apoptosis (cell death) in breast cancer cells, but not affecting normal cells, showing cytotoxic effects that may be very useful in prevention as well as an adjunct in treatment: http://www.ncbi.nlm.nih.gov/pubmed/24231340
  45. Research in Argentina in 2006 found that parthenolide in Magnolia grandiflora and Feverfew was effective in vitro in achieving dose dependant nontoxic cell death of cancerous B-cells in chronic lymphocytic leukemia: http://www.209.85.173.132/search?q=cache:OdzpuJNgUvgJ:www.zsf.jcu.cz/jab/4_3/marin2.pdf+herb+herbal+chronic+lymphocytic+leukemia&cd=36&hl=en&ct=clnk&gl=us&client=firefox-a
  46. Research in France in 2006 found that St. Johns' Wort, or Hyperforin, was effective ex vivo in achieving dose dependant nontoxic cell death of cancerous B-cells in chronic lymphocytic leukemia, and also inhibiting the cancer cell capacity to secrete a chemical that stimulates the cancerous creation of new blood vessels: http://www.nature.com/leu/journal/v20/n4/abs/2404134a.html
  47. Research in 2008 at the University of Alabama Birmingham's Department of Comprehensive Cancer Center found that proanthocyanidins in whole grape extract prevented the malignant spread of metastatic cancer in a number of novel metabolic ways: http://www3.interscience.wiley.com/journal/121369644/abstract?CRETRY=1&SRETRY=0
  48. In 2001, Japanese researchers at Ehime University School of Medicine proved that resveratrol from the Chinese herb Polygonum Cuspidatum (Hu zhang) prevents tumor growth and metastasis in lung cancer, as well as tumor induced neovascularization: http://jn.nutrition.org/cgi/content/full/131/6/1844
  49. A 2009 study at the University of Texas found that the herb Trypterygium Wilfordii (Lei gong teng) contains an active chemical that is a potent inhibitor of COX-2 and VEGF, as well as inhibition of the receptors for the thrombin receptor CXCR4, TNF and TGF-beta, making this a potent anticancer agent: http://www.ncbi.nlm.nih.gov/pubmed/19922946
  50. A 2015 study by cancer experts at the University of Minnesota School of Medicine showed that progesterone and progesterone receptors play varied roles in types of cancers, with progesterone inhibiting estrogen-driven cancer growth in the uterus and ovaries, while altered isoforms of progesterone apparently acting in concert with estrogens to promote anti-apoptotic cell mechanisms and cancer proliferation. The balance between progesterone receptor types A and B is the key to the contribution in breast cancer, and homeostatic mechanisms that maintain a healthy balance of receptor expression, as well as overall hormonal balance and metabolic needs in local tissues such as DIM and aromatase conversion, are most important. Such study confirms the importance of establishing hormonal balance and function and supports the use of bioidentical progesterone creams used professionally to achieve this homeostatic balance. Such therapy in a holistic protocol could be preventing many cases of these cancers: http://www.ncbi.nlm.nih.gov/pubmed/25587053