(First draft only - view with caution. Version 08-03-00- www.PatientsNCI.org)
·By Recovered Patients
·Not For Profit
PATIENTS' PROTOCOL STEP 2
HEALTH WORKUP AND TESTING
Part 1 of 2
INTRODUCTION AND GUIDELINES
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NOTE ON BIOPSIES:
Most physicians recommend against unnecessary invasive testing. This includes unnecessary biopsies, X-rays, mammograms, exploratory surgery, etc. Risks can include infection, hemorrhage, internal scarring and most serious, metastasis. But when are these tests therapeutically necessary, and when are they just an automatic routine?
In alternative therapy, taking biopsies early for staging or grading could become irrelevant, since tissue could soon change back toward normal. If invasive tests can be postponed safely until after alternative therapy, and just before anticipated invasive therapy, it may turn out that neither one is needed after all.
More and more physicians prefer to use newer blood tests and modern non-X-ray imaging instead of invasive testing. They are finding these safer tests may be more accurate than some biopsies, especially when they are combined with the AMAS or AMID blood tests, discussed in Part 2 of this step.
Are biopsies becoming obsolete? Considered the gold standard back in 1970, they have now become an automatic routine, often ordered by habit without fully informing the patient of the risks involved. More critical studies have put their overall accuracy at 75% or lower, in some cases. Compare this with the AMAS blood test discussed later, which journal studies find to be 95% accurate, reaching 99% upon repeat testing.
Other medical journal studies show that imaging and measurement of the tumor volume can be a better prognosticator than biopsies.
Of particular concern are the "rush" biopsies done while the patient is waiting in the operating room. Journal articles worry about the training and experience needed to make smears good enough for accurate diagnosis, and of complications such as benign dysplasia and sclerosing adenosis, which make distinction from carcinoma difficult. Never the less, "rush" biopsies are still recommended in these articles for their "cost-effectiveness."
There have been attempts to compensate for the growing concern about biopsy accuracy, especially false negatives. Compensation can take the form of questionable multiple-biopsy guns, sometimes taking 5 or even 10 biopsies in one procedure.
This also multiplies scarring which might interfere with the normal performance of the organ and provide places for cancer cells to hide from the immune system. Scarring also interferes with safer diagnostic imaging techniques. Infection and hemorrhage may be additional complications in roughly 1-3% of biopsies. Each of these risks might be multiplied by the number of biopsies.
Logically, the risk of metastasis could also be multiplied by the number of biopsies.
In the eyes of recovered patients, one of the main problems with invasive testing is that it may start a launch sequence. In some cases, it seems to put the patient on an accelerating treadmill which leaves little time for alternative therapy to take effect before being rushed into invasive therapy.
Patients report that biopsies and other invasive tests were sometimes followed by more rapid growth and spreading of the cancer. Perhaps these invasive procedures disrupt a defensive perimeter that the immune system may have established around the cancer to check its growth. It could be analogous to a boil which traps an infection, until it is lanced and everything runs out. Whatever the reason, journal studies seem to support patients' suspicions, at least in some instances. After biopsies, cancer progression can accelerate from a slow pace of years, to only weeks or even days in certain cases.
Journal studies confirm that biopsies and exploratory surgery can spread cellular debris throughout the circulatory system. The rates reported do not agree. They range widely - from nearly zero, to over half of the time. But practically speaking, the risk of metastasis from that debris seems to be small (perhaps in the range of 1-3%) provided :
If a biopsy is truly needed, patients should discuss the technique to be used with the doctor, and emphasize the desire to minimize risks. For instance, one journal study found that the use of a prostate biopsy technique called "transurethral resection" resulted in doubling the rate of recurrence and of deaths compared to the risks of fine-needle biopsies.
Extensive research confirms that invasive tests such as X-rays, including the often-recommended mammograms, can cause new cancers. Like biopsy metastasis, they may not become large enough to be detectable for 5 - 20 years.
This common latent period means these statistics are not revealed in the typical shorter-term safety studies. This also suggests that the dangers of metastasis may be significantly understated in much of the medical literature that doctors read.
The bottom line is that many journal studies show no statistical improvement in survival time when a biopsy is used, compared to not using a biopsy.
On the other hand journal articles seldom go so far as to recommend undertaking the major risk of invasive therapy without the minor risk of a biopsy.
We tend to support the opinion of the Department of Surgery, Lund University Hospital, Sweden. They agree that risks are "probably underestimated ...[and recommend that biopsies] should be restricted to patients who will truly benefit from a more accurate preoperative diagnosis."
We read this advice as meaning that biopsies may not be needed to undertake the safer treatments of alternative therapy, such as diet, provided other accurate, non-invasive tests are used.
Patients and doctors who want an authoritative update on biopsy seeding can do a keyword search on Medline using the key words, biopsy and seeding. This is where much of the above material was obtained.
A. TESTING TIPS
Be reminded that these are the opinions of recovered patients, not medically trained physicians who are familiar with your particular case.
1. Discuss our preference for non-invasive testing with the doctor. We would specifically discuss using the AMAS or the AMID tests and non-X-ray imaging. If they were not sufficient, we would check for newer tests at the national cancer centers and the world wide web. We would ask the doctor if it would be safe to postpone invasive tests until after alternative therapy and just before potential invasive therapy, if it is still needed then. If the doctor is still reluctant, we would get a second opinion.
2. If a second opinion (preferably from a physician trained in alternative-medicine) confirmed that there were no satisfactory alternatives to invasive tests in this case, we would consult with the doctors about:
a. Selecting a technique that is least likely to cause metastasis
b. Immediately taking steps to prevent potential spreading as covered in PATIENTS' PROTOCOL STEP 3, Suppress Metastasis.
c. Immediately stimulating the immune system to destroy possible escaping cancer cells, as explained in PATIENTS' PROTOCOL STEP 7, Enhance Immunity.
Note: It is essential to do this in consultation with the doctor, because of possible therapeutic conflicts.
3. When the results come back, we would consider getting a second opinion - especially before deciding on expensive or invasive therapy. If it was so important to take the biopsy, it must be equally important to read the results correctly. On rare occasions, even three pathologists will have three different opinions. In cases of differing opinions, we would ask for explanations of why they interpret things differently.
4. We believe that, if the patient were fully informed of the risks of invasive testing, it might be possible to reduce or eliminate these risks by appropriate follow up. For example, alternative therapy could maintain the immune system at a higher state of vigilance until the AMAS test indicates leaked cancer cells have been gone for a reasonable period of time.
B. WHY A COMPLETE HEALTH WORK-UP IS IMPORTANT
Conventional therapy uses tests to establish baseline values for the cancer and for the immune system. This is also essential for good alternative therapy, and must not be overlooked.
Alternative therapy may do a complete physical and health work-up to find:
1. What other conditions may be interfering with the body's battle against cancer.
2. Why the body's powerful anti-cancer armies missed this cancer.
3. How to restore these armies, to help the body eliminate this cancer and protect against future cancers.
4. The probable cause of this cancer so the situation can be prevented in the future.
To find the cause may take detective work, based on the patient history, employment, lifestyle, etc. Remember that most cancers are 5 - 20 years old before they are detected, so the trigger probably happened back then. But the cause could be continuing, so it is still important to identify it now if possible. Also it may gives clues to treatment.
For example, if a lung cancer patients used to smoke 5 years ago, it may not be hard to figure out what caused the lung cancer in the first place. But if the patient stopped smoking then and the body still hasn't been able to eliminate that cancer by now, it implies the body has lost some of its abilities to protect itself against future cancers.
Identifying and restoring that capability is how alternative therapy cures cancer. This is why the complete health work-up is so important.
NOTE: Re-testing for current medications may be required. Alternative therapy to reverse cancer can be so healthful that other diseases often start clearing up as well. It is not uncommon for doctors to have to reduce or eliminate medications for heart disease, arthritis, diabetes, etc. These levels must be carefully monitored during alternative therapy, so they don't become excessive.
C. HEALING REACTIONS
Patients and doctors should be prepared psychologically for the temporary exacerbation that occurs in some tests when the immune system is made stronger and unleashes a more intensive attack on the cancer. Pain and swelling may also increase for a week or two.
The rule of thumb is that the higher the spike and the worse the symptoms become temporarily, the better the prognosis. It can indicate the therapy has mobilized the immune system to work at a much higher level.
Monitoring of detoxification can become critical at this time as dying cancer cells flood the body with toxins which must be dealt with rapidly. Detoxification organs include kidneys, liver, bowels, skin and lungs. More details will be covered in PATIENTS' PROTOCOL STEP 6, DETOXIFY.
D. "CANCER GENES"
Don't be psyched out by tests that find what the media calls "cancer genes." Wiser scientists have explained that such genes may only indicate a tendency among certain groups to get cancer more frequently. Often these higher risk groups are smokers or meat-eaters. A patient may be able to leave those high-risk groups behind simply by changing life-style or diet.
For example such genes might be considered "vegetarian genes." And the patient might get well and stay cancer free by eating their genetic vegetarian diet.
E. NEWER TESTS
Newer tests require more caution. They may be too new to have an adequate cadre of experienced technicians, so the tests may not be performed consistently. Or there may be differing schools of thought about how to interpret newer tests. Or there may be very limited data to determine the reliability.
IN ALTERNATIVE CLINICS, live blood cell analysis and dark field microscopy seem very promising. But use of the technique is relatively new and some practitioners still disagree about how to interpret the results.
We classify "muscle-testing" under newer tests because it remains unproven. Do not confuse legitimate physical therapy called "Kinesiology" with muscle testing of remedies, which has borrowed the same name. Some think muscle testing worked for them, others scoff that they got as many wrong answers as right.
The basic premise that the body may flinch when confronted with something it recognizes as threatening, or when a suffering organ is pressed, seems to be supported. But the leap of faith that leads to the extension of using muscle testing to predict the efficacy of future remedies the body hasn't tried is the most questionable part.
We have yet to find any double-blind studies where the accuracy was better than pure chance. So be warned.
IN CONVENTIONAL RESEARCH LABS, the new "tetramer" technology combined with recent functional assays such as ELISPOT or intracellur staining (ICS) is providing immune system analysis that is 10 - 20 times more accurate than previously possible. If there are problems with PATIENTS' PROTOCOL STEP 7, ENHANCE IMMUNITY, these new tests may be ready in time to help.
When considering the reliability of newer tests, there are three key numbers that tell a lot:
Newer tests can be helpful. Ask for those three numbers to evaluate them. Be cautious about relying on them for major decisions. It's especially desirable to confirm with a seasoned test when considering expensive therapy or invasive procedures.
F. EDITORIAL OPINION
We don't put too much reliance upon any single test. After 20 years of helping each other through medical minefields, we get the impression that as many as 1 out of 3 tests may be wrong. Beyond false negatives and positives, values can be a little off or they can be dead wrong.
In one case, no one at the hospital thought it would be necessary to re-test the blood type before a standard transfusion. The patient died from a mismatch in a few hours. In another case, the patient's ombudsman advised him to wait an extra day (and to pay double) to have his transfusion double-checked. That caught an error that would have been fatal.
Errors can be introduced all along the chain, by the patient, the technician, the nurse, the doctor, the laboratory, the time of day. Learn about each test. Check the results yourself. Are they consistent with previous results? Are trends in the right direction? If not, what can be done about it? Should this test be confirmed by repeat or by some other method before making a key decision?
On the one hand we have to protect ourselves against the risk of impersonal tests that have no common sense, and could be way off base. On the other hand, it could be much riskier not to measure and test enough. There's little time to waste on therapies that are not working as promised.
End of Part 1, Introduction and Guidelines
of PATIENTS' PROTOCOL STEP2, HEALTH WORK-UP AND TESTING
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Frequently Used Tests
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