Changes in direction of cancer research over the 20th century: What prompted change - research results, economics, philosophy Jennie Burke Master of Science (Honours) A thesis submitted to the University of Western Sydney April 2007 © Jennie Burke 2007 Changes in Cancer Research: Research Findings, Economics, Philosophy Jennie Burke – April 2007 Dedication This research is dedicated to the cancer patients who have so willingly shared their stories with me over the last two decades, and to future patients who will hopefully fare better. I also dedicate this work to my darling grand-daughter, Sophia, and to her generation in the hope that, by her adulthood, cancer will be prevented rather than treated. If in the future treatment for cancer is necessary, my wish is that such treatment will be humane and patient focused. Changes in Cancer Research: Research Findings, Economics, Philosophy Jennie Burke – April 2007 Acknowledgements I wish to thank my supervisor, Stuart Hill, for his patience, support, good cheer and assistance in all facets of this work. I am indebted to my brother, Michael Howe, for his support, critiques and his wealth of knowledge of the legal system in Australia. My thanks and appreciation must go to Dr. Karen Bridgman and Professor Andras Szasz for their support, wisdom and scholarly advice. My friends who are medical practitioners have cheerfully spent long hours in discussion relating to this study, and I thank them for their patience and clear-sightedness. Thank you to Megan Mathews and Giselle Cooke. During the writing of this thesis, I have been privileged in having the support of two exceptional scientists. Firstly, Dr Horace Drew III, a molecular biologist of world renown, has provided advice on matters of science. I am convinced that his open- mindedness, intelligence and curiosity, if shared by the majority of scientists, would improve all areas of science. Dr Maxine McCall has shown amazing patience in spending time with me in discussion and in listening to my airing of concepts. I thank you both. My daughters, Kerri and Moya, have offered support and encouragement in this endeavour and have never doubted my ability to finish this work. The staff at my laboratory have also given help and support in large quantities. Jane Howard, Linda Tutty and all the staff have worked harder to compensate for the time I have taken off while writing. Their help has been most appreciated. I would like to express my sincere appreciation for the time given in proof reading by both Robert Gammal and Sharon Millyard. Without Sharon’s assistance, in particular, this paper would not have been finished in a timely manner. I thank you all very much for your assistance in bringing this thesis to reality. Changes in Cancer Research: Research Findings, Economics, Philosophy Jennie Burke – April 2007 Statement of Authentication The work presented in this research is, to the best of my knowledge and belief, original except as acknowledged in the text. I hereby declare that I have not submitted this material, either in full or in part, for a degree at this or any other institution. … … Jen Changes in Cancer Research: Research Findings, Economics, Philosophy Jennie Burke – April 2007 Table of Contents Abstract 1 Introduction 2 The Origin of This Study 2 Investigating Links Between Bacteria and Cancer 2 Challenging Scientific Tenets 3 Questioning Medical Doctrines 4 Addressing the Medical Paradigm 5 Direct Conflict with the Medical Establishment 7 Scope of the Study 9 Organisation of the Research 10 Part I: Background 10 Part II: Research Findings 10 Part III: Economics 11 Part IV: Philosophy 11 The Hypothesis 12 PART I BACKGROUND 14 Chapter 1 Methodology 15 Literature Review Using a Hermeneutical Approach 16 Case Studies 17 Qualitative Interviews 18 Literature Survey: Sources 20 Criticism in the Popular Press 20 Literature that Focuses on Quality of Life 21 Questioning the Medical Power Base 21 Questioning the Influence of Industry 22 Challenging the Halls of Academe 23 Promise or Statistics 23 Sources for Statistics 24 Conspiracy Theories 24 Investigative Journalism 24 i Changes in Cancer Research: Research Findings, Economics, Philosophy Jennie Burke – April 2007 Historical Sources 25 Philosophical Sources 25 Sources for Social Systems 25 Scientific Sources 26 Newspapers, the Popular Press and Websites 27 Governmental and Legal Sources 27 Interpretation and Bias 27 Literature in the Context of People 28 Chapter 2 A Century of Cancer Statistics 31 19th Century Death Toll from Tuberculosis 32 20th Century Death Toll from Cancer 32 Escalation of Cancer to the Leading Cause of Death 32 Increase of 245% in Cancer Deaths over 60 Years 33 Australian Cancer Rates 33 Future Predictions 33 Demographics of Cancer Increase 34 Increase in Smoking-Related Cancers 34 Increase in Cancers Caused by Infection 34 Effect of Affluence on Survival Rates 34 Increase in Hormonal Cancers 35 Measures of Success: The Death Rate 35 Death Rate Statistics 35 Australian Figures 35 USA Figures 35 Cancer Deaths in the Third World 36 Misclassification of Cancer Deaths 36 Cancer Deaths Classified as ‘Other Causes’ 37 Deaths from Cancer Treatments 37 Disagreement Between Diagnosis and Autopsy Results 38 Are Published Figures Correct? 39 Measures of Success: ‘5-Year’ Survival Rate 39 Are Treatments Increasing Cancer Statistics? 41 Chemotherapy Drugs As Carcinogens 41 ii Changes in Cancer Research: Research Findings, Economics, Philosophy Jennie Burke – April 2007 Radiotherapy As a Carcinogen 41 Conclusions 42 PART II RESEARCH FINDINGS 45 Chapter 3 History of Cancer Research: Cause and Treatment 46 Early Cancer Research 47 Earliest Mentions of Tumours: Humors or Black Bile 47 18th Century: Tissue Capable of Destructive Growth 47 19th Century: Tumours Derived from Normal Cells 48 Cancer from Normal Tissue, Metastasis via Blood or Lymph 48 1920s: Respiration in Cancer Cells 48 1928: Dismissal of Theory of Causal Parasite in Cancer 49 Epidemiology of Cancer 49 Early Recognition of Tobacco As a Causal Agent 49 1950s: Epidemiological Studies of Smokers 50 Enzymatic Studies of Cancers 50 Genetic Studies of Cancer 51 Gene Repression from Oncogenic Agents 51 DNA and Genome Mapping 51 Discovery of the Breast Cancer Gene BRCA 1 51 Recognition of Viruses as a Causal Agent 52 A Century of Chemotherapy Treatment 52 The First Chemotherapy Drugs 53 Chemotherapy Usage 53 Newer Treatments 54 The ‘Magic Bullet’ 54 A Century of Radiotherapy 54 First Clinical Uses 54 Research into Heavy Particles 55 Utilising Radiation Damage to Cells 55 New Radiation Regimes 55 A Century of Surgery 55 Radical Mastectomy 56 iii Changes in Cancer Research: Research Findings, Economics, Philosophy Jennie Burke – April 2007 Modern Surgery 56 Success Dependent on Surgeon’s Skill 56 Forms of Surgery 56 Results of Research 57 Losing the War on Cancer 57 Epithelial Cancers Increasing and Difficult to Treat 57 Chemotoxic Agents Have Little Impact on Most Common Cancers 57 A New Paradigm—Understanding Therapeutic Resistance 60 Tamoxifen Has Negative Effects on Survival from Breast Cancer 61 Response Rate to Oncology Drugs Only 25% 61 Postoperative Radiotherapy Increases Mortality 61 Future Harm from Radiotherapy 62 Conclusions 62 Chapter 4 Bacterial Involvement in Cancer 67 Early Research on Bacteria 67 Pasteur: Bacteria as Cause of Disease 67 Koch: The Rise of Bacteriology 68 Koch's Postulates 68 Monomorphism 68 1884: Tumours Contain Parasites, But Are Not Caused by Parasites 69 1889: Parasites Found in Cancers 69 1885: Cancer Vaccine from Bacteria 70 1899: Histology Shows Parasites in Active Parts of Tumour 70 1911: Virally-Induced Cancer 70 1925: Micrococcus Cultured from Breast Cancer 70 1925: Cancer Induced by Virus with an Irritant 71 1930: Pleomorphic Forms from Cancerous Tissue 71 Further Studies on Pleomorphic Forms 71 1941: Pleomorphic Forms from Hodgkin’s Lymphoma 72 1948: Siphonospora from Cancer Tissue 72 1952: Pleomorphic Studies of Micromyces 73 1955: Cancer ‘Virus’ Extracted from 1000 Cancers 73 Early Drugs Utilising Bacterial Effect on Virus 74 iv Changes in Cancer Research: Research Findings, Economics, Philosophy Jennie Burke – April 2007 1955: Dark Field Microscopy Reveals Pleomorphic Forms in Blood of Cancer Patients 74 1959: Scientist Self-Inoculates with Carcinoma Isolate 74 1948–1990: Livingston-Wheeler et al, Pleomorphic Studies on Neoplasms 75 1966: Studies on the Rous Virus As a Pleomorphic Form of Mycoplasma 76 1969: Livingston-Wheeler Cancer Clinic and Autologous Vaccine 76 Late 1990s: Positive Responses from Clinic Patients 76 1973: Link Between Bacterial Endocarditis and Colorectal Carcinoma 77 1970s–1980s: Histology of Pleomorphic Forms in Cancers 77 Cell Wall Deficient Forms and Mycoplasmas 77 1993: Mattman on Cell Wall Deficient Forms 78 Late 20th Century: Mycoplasmas in Gulf War Syndrome Patients 78 Mycoplasmas Inducing Chromosomal Instability and Malignancy 79 Affinity of Mycoplasmas for Cancer Cells 79 Stats on Infection of Cancer Patients with Mycoplasmas 80 Connection Between Helicobacter pylori and Gastric Cancer 80 Early Misclassification of Mycoplasmas and Cell Wall Deficient Forms 80 Renewed Interest in Bacterial/Viral Induction of Cancer 81 High Incidence of Infection in Cancer 81 Salmonella Infections Linked to Gall Bladder Cancer 81 Chlamydophila pneumoniae in Lung Cancer 81 Escherichia coli and Streptococcus bovis in Colon Cancer 82 Infection in Oral Squamous Cell Carcinomas 82 Conclusions 82 Chapter 5 Paths Not Followed 86 Environmental Carcinogens 86 Role