Rarely do we defeat cancer | Dec. 6, Perspective story
We're gaining in war on cancer
It is not difficult to understand why Dr. John L. Marshall of the Lombardi Comprehensive Cancer Center has such a negative opinion of the current status of cancer treatment in the United States. He is a medical oncologist who treats only advanced and metastatic gastrointestinal cancers (pancreas, stomach, esophagus, small bowel and liver, for instance), and is rarely rewarded with the satisfaction of actually curing a patient.
His somewhat jaded opinion of the overall effectiveness of current regimens in the treatment of early stage cancers of the prostate, breast, colon and rectum, head and neck, skin, cervix and uterus, lymphatic system, and even some lung cancers is at odds with reality. Primary care physicians in our community fully expect that the majority of their patients in the above categories will be cured upon referral to medical and radiation oncologists and surgical specialists for treatment. Advanced disease and certain other treatment-resistant cancers comprise categories that should define the direction which medical research must take.
Unfortunately, Dr. Marshall's critique of current clinical trials in his seventh paragraph is absolutely accurate. These trials indeed are not designed to "cure" patients, but rather to identify small gains in survival or other endpoints at great cost to the patient in side effects, and to society in monetary cost. His estimate of five to six months survival extension from these trials seems generous based on these studies published in the medical literature. Too often in academic settings, convoluted statistical manipulations and the need to publish "research" papers trump a more effective approach to this spectrum of disease we call cancer.
Fortunately, the graphic included with this article contradicts much of the pessimism expressed by Dr. Marshall. It is demonstrably true that "Screening for early detection and better treatments have improved mortality rates for breast, prostate and colon cancers." Since the early 1990s, we have finally begun to win the war on cancer, not by great leaps but by incremental victories. A summary of the overall progress in cancer survival was recently published in the journal Cancer.
John West M.D., Largo
Rarely do we defeat cancer | Dec. 6
Rely on the evidence
Dr. John L. Marshall gives an example of the distinction between an evidence-based medicine model and our current "hope-based" model. Under the "hope-based" model, we spend a vast sum of money on cancer treatment that is no more effective than no treatment at all based on the patient's hope that it might work. Under evidence-based medicine we would determine through properly conducted studies which treatments work and which do not.
Instead of funding ineffective treatment as we now do, pooled funds would be used only for effective treatment. (As now, anyone would be free to spend their own money on ineffective treatments.) The money now spent on ineffective treatment would be spent on research to find effective treatments. Under evidence-based medicine, no cancer patient is worse off in the short term and all cancer patients will benefit in the long run.
Ed Bradley, Lithia
Toward a natural religion | Dec. 6, Perspective story
Doomed to fail
Bron Taylor's article is yet another reincarnation of an ages-old theme, dressed up in modern science. It will suffer the same fate, and for the same reasons.
Man's search for meaning in life cannot be satisfied with egalitarian ideology. According to Darwin, man is little (if anything) more than an ape with opposable thumbs and some extra neurons.
True religion recognizes in man a divinely created spirit, with a special meaning, purpose and plan that is not for a lifetime, but for eternity. True religion cannot come from man. It is not contrived, not arbitrary. We do not find God. He finds us.
That is why all past attempts to invent a "convenient" new religion have failed.
Robert Arvay, Tampa
Toward a natural religion | Dec. 6
There's little conflict
One only need look at the various position papers (found in Voices for Evolution) of the mainline religions regarding evolution and the teaching of evolution in the public schools to see that there is now little conflict between the majority of religions' tenets and evolution.
However, I thought it unfortunate that Bron Taylor didn't provide the entire quote he used from the On the Origin of Species. The full quote is: "There is grandeur in this view of life, with its several powers, having been originally breathed by the Creator into a few forms or into one; and that, whilst this planet has gone cycling on according to the fixed law of gravity, from so simple a beginning, endless forms most beautiful have been and are being evolved."
Theistic evolution, the belief that God created through evolution, could be what Darwin meant by that passage, at least when he wrote those words more than 150 years ago.
N.J. Marsh, Tampa
Hey, Publix, pony up a penny a pound Dec. 6, Robyn Blumner column
Do what's right
Amen to Robyn Blumner in highlighting the plight of the farmworkers who pick tomatoes in Florida that Publix sells every day.
Many groups have banded together to join the fight, including the Coalition of Immokalee Workers and the United Methodist Women picketing right here in St. Petersburg.
Although Publix has made Fortune's 100 Best Places to Work in America since 1998, it needs to do what is right and just for these farmworkers.
Lorena Walton, St. Petersburg
Last Sunday morning I opened up the St. Petersburg Times for my usual read. After checking the obits (to see if my name was there) I turned to the Perspective section to check out the crossword puzzle and noticed on the opposite page an article titled, Dept. of bad ideas: Shelve this gift. I saw the accompanying picture and decided to read on.
All I can tell you is, I don't think I've laughed that hard in a few months. After reading it, I called three of my friends and my sister so they could have a good laugh, too. My sister called me back and said she was going to call her sister-in-law and tell her that the Steering Wheel Desk Tray was going to be her Christmas present this year.
Just thought you should know that this article brought me a lot of Christmas cheer.
Juanita Workman, Pinellas Park