FROM ALTERNET: http://www.alternet.org/story/147575/?page=entire
In a breakthrough in the treatment of multiple sclerosis, last summer
Dr. Paolo Zamboni, a vascular surgeon from the University
of Ferrara in Italy, made public the results of findings from his study of 65 MS patients.
Dr. Zamboni and colleagues investigated CCSVI -- Chronic Cerebrospinal Venous Insufficiency -- a condition characterized by blockages in the veins causing problems in the blood flow drainage from the brain and/or spinal cord of sufferers. This condition has been shown to contribute in a significant way to the many symptoms of multiple sclerosis. It can be relieved by angioplasty, which is a simple surgical treatment that removes the blockages.
Despite the results of Zamboni's and other significant studies, my research
into the media's coverage of angioplasty as a
treatment for multiple sclerosis reveals that the mainstream media, with some notable exceptions (examples of which are here,
here and here) , is generally presenting arguments that are favourable to maintaining the pharmaceuticals' monopoly on
treatment options (examples here, here and here). Overall, the media has failed to do its journalistic duty to research all sides of
the issue. They have failed to take the numerous testimonials and positive research results seriously and are failing to take into
account the costs and benefits of angioplasty versus those of MS drugs that in the end offer little to no long-term benefits.
Pharmaceuticals provide millions of dollars every year to MS Societies
in the U.S. and Canada, and the MS Societies in turn
advertise the drugs developed by the pharmaceuticals and encourage their members to have full confidence in these drugs, even
when alternative treatments, such as diet and angioplasty, might be more effective in alleviating the symptoms of the disease.
In fact, the MS Society of Canada claims to receive less than two per
cent of its funding in pharmaceutical grants -- see Myth
#2 in the link above. Additional direct assistance to the MS Societies of Canada and the US would be in the form of free
education materials, speakers, and expertise, as well as paid advertising in MS Society newsletters; however, total assistance
would certainly be a relatively small percentage of total budget, hundreds of thousands in Canada and millions in the U.S., but
direct assistance is perhaps not the main source of influence on MS Society decision making.
Eminent neurologists and MS research foundations also receive extensive
funding from pharmaceuticals, as revealed in a full
disclosure article critical of CCSVI treatment that appeared in the Annals of Neurology (Khan et al, January 2010, Annals of
In addition to funding their research, the pharmaceutical industry also
influences through leaders -- see below -- through an
educational organization known as the "Consortium of Multiple Sclerosis Centers." Page two of the report explicitly states that
the CMSC is a partner with the pharmaceutical industry, other non-profit advocacy and services organizations (which would
include MS Societies), and MS professional organizations.
Seven of the 11 authors of the report (including the first four, senior
authors) disclosed receiving significant financial support
from pharmaceuticals that produce drugs for MS. In addition, the pharmaceuticals are key players in an organization known as
the "Consortium of Multiple Sclerosis Centers" whose main function is to influence MS thought leaders such as neurologists,
researchers, and directors of MS Societies.
The medical establishment, in general, is hesitant to embrace a finding
that would shift some of the burden of treatment for MS
from neurologists to interventional radiologists, vascular surgeons, and experts in blood flow and imaging. One can only
speculate about why this shift is so difficult for them.
One factor might be professional pride, but a more important factor
might be the re-training that is necessary, both for doctors
and technicians. As it stands now technicians lack the training to detect the blockages, even when they have the latest Doppler
ultrasound equipment; and surgeons are flabbergasted at the thought of performing interventions on veins, which unlike arteries,
are pliable and difficult to manipulate.
The upfront investment required to support the required changes, which
would affect personnel and equipment, is also an
impediment to recognition of CCSVI treatment by provincial health plans. So despite the enthusiastic support of both the
Liberal and NDP health critics at the federal level, without federal financial support, changes at the provincial level may be slow
in coming. In fact, the upfront cost would quickly be recovered as use of MS drugs became less common.
It is not surprising, then, that the mainstream media, when it follows
the lead of the medical establishment and the MS Society,
presents a biased picture that does not contribute to our understanding of the costs and benefits of CCSVI treatment. MS
patients demanding the right to angioplasty for CCSVI are often depicted as a mere advocacy group attempting to badger the
scientific community because of their hope for a miracle cure. The hundreds of positive reports and internet videos depicting
MS patients who have benefited substantially from the treatment are dismissed as mere testimonials with no scientific merit.
Then there are the weasel words that are used to depict MS patients
as emotional, subject to the whims of an unpredictable
disease characterized by attacks and remissions, which renders them susceptible to quackery, psychological boosterism, and
the much touted "placebo effect." Angioplasty itself is often referred to as "the liberation treatment," which suggests the wild and
radical aims of those advocating for it. Research directors working on projects funded by pharmaceuticals and spokespersons
from the MS Society are frequently quoted speaking out against the treatment without regard for the inherent bias such
spokespersons would be expected to have.
The Canadian Medical Association Journal recently featured an editorial
in which it argued that the medical establishment was
on the side of the plain folk, guarding them against being overwhelmed by unproven therapies that had not been evaluated for
safety and effectiveness, while preventing public monies from being diverted for use in untested procedures.
The truth is that despite concerted efforts to depict it otherwise,
the issue here is not one of science but one of ethics. There is
already ample evidence that the treatment has a high probability of being beneficial to a large number of MS patients.
Detractors, however, raise the question of whether the costs outweigh the benefits. There is, in fact, ample evidence for those
willing to take the time to look for it that this question has been amply answered in the positive (see here and here).
Angioplasty, which is a medical procedure of long standing, can easily be adapted to treatment of CCSVI, and the treatment
works. Why it works is still undetermined, but no one is arguing that it works by some mysterious energy or Elan vital. There
are several promising leads (such as build up of iron within the brain) that can be the subject of future scientific investigation.
Patients themselves are amassing the evidence of success on the electronic bulletin boards of websites like "This Is MS." The
videos are very moving, and it is hard to dismiss them as anything but overwhelming evidence for the effectiveness of the
Detractors like to point out that the benefits of the treatment cannot
be considered long-term because veins are subject to
collapse after stretching. However, even if the veins collapsed again and needed to be re-stretched annually, this would still be
more cost effective than most MS drugs, which cost up to $30,000 per year and marginally slow the course of the disease at
In fact, recent studies have suggested that the so-called CRAB drugs
have no statistically significant long-term effects. CRAB
drugs are Copaxone, Rebif, Avonex, and Betaseron, the standard drugs used to treat MS. They are administered by injection
and cost up to $30,000 per year. Because we don't have a pharmacare program in Canada, the cost of these drugs can be a
considerable burden to those lucky enough to be able to afford them at all.
In addition, using vein stents (no this is not a new technology either) could eliminate the need for additional treatments.
CCSVI itself is characterized in the mainstream media as unproven and
controversial. Maybe, after all, it is a fairly normal
condition. However, CCSVI is not controversial. It has been unanimously recognized by an expert international body as an
undesirable congenital malformation. In 2009, at a conference on venous malformations (UIP09), experts from 47 countries
voted unanimously in favour of officially including the stenosing lesions found in CCSVI in the phlebology consensus document
How dangerous is the treatment? As of today, the treatment has been
applied over 1,000 times with reports of only one death
following improper placement of a stent. Many MS patients, whose lives are in ruins, are willing to take the risk. And the risk
can be compared with the risk of taking MS drugs, which are very unpleasant and hardly risk free. For example, a common
drug for MS causes liver damage. Another recent study suggests that there are two types of MS -- similar symptoms but
different diseases -- and if you treat one of the types of MS with one of the commonly prescribed CRAB drugs you may
actually make the disease worse.
The medical establishment is demanding double-blind testing on the Zamboni
method, which works well on drugs but is almost
impossible to do with a surgical intervention. There is, of course, the questionable ethics of not correcting obvious problems
once the surgical intervention has begun. In addition, given that the patients are not under general anaesthesia during the
procedure, and in light of the fact that most doctors are probably lousy actors, the blind is going to be hard to maintain.
The University of Buffalo has received funding to try a double-blind
test on a small sample, but any results are almost certain to
be contested. The small sample size itself creates a problem because of the danger of sample bias, which is all the more likely
as MS, unlike say breast cancer, is such a multi-faceted disease. Ideally you would want patients that were similar in
background, venal malformations, and symptoms, except some would be given the treatment and some not. Unfortunately, this
similitude is going to be impossible to achieve.
Double-blind testing does make sense for drugs, where the blind is relatively
easy to maintain and ethics may be less of an issue
when the benefits of the drug really are uncertain. It would seem that more usual for surgical interventions is to try it if it seems
to work, and evaluate based on tracking of results over multiple treatments.
Perhaps this is what Dr. Zamboni means when he says that every Canadian
should be given the treatment but also that the
treatment should be given in a context of scientific study. This try-and-track approach was used with the original angioplasty
procedures that were performed on arteries in the 70s, for example. It has also been used with radical mastectomy for breast
cancer and caesarean sections, both of which have lately been given a serious re-evaluation. One notable procedure that the
try-and-track approach was used on was scoping of knees. Now, after over a million trials, it would seem that scoping is being
rejected as a valuable treatment.
Blind testing of drugs seems to suffer from a problem that is the contrary
of the try-and-track approach. Once a drug is
approved it may readily be prescribed for conditions that don't meet the test specifications. Notably, it may also continue to be
prescribed even when tracking suggests that it may be dangerous under certain conditions. This appears to be the case with one
of the commonly prescribed CRAB drugs, which as mentioned before under certain conditions may actually make the disease
There is also a danger that the medical establishment will dismiss the
benefits by setting the bar too high. Keeping in mind that
the only long-term benefit of the CRAB drugs appears to be modulation of the attacks (so that the disease progresses just as
quickly but with less serious attacks and remissions), we should not expect immediate and obvious benefits from every
treatment. Benefits may, after all, be both restorative and preventive. Those in the early stages of the disease might not perceive
any benefits even though unblocking their veins might prevent future deterioration. Those in the middle stages of the disease are
most likely to notice perceptible benefits. Those in the final stages of the disease, after their muscles have atrophied making
recovery impossible, might not notice any benefits, but at least they would benefit from prevention of further deterioration.
Some patients have complained that perceived benefits are fleeting,
lasting merely months. Indeed, if their veins collapse again
they may need to travel once again to Europe to have the treatment redone. Unfortunately, travelling abroad can easily cost
$15,000, so can't be repeated too frequently. The solution is, of course, to make the treatment locally available, then it would
cost only a few thousand dollars at most. Even if this procedure needed to be repeated annually, it would be much cheaper than
treatment with MS drugs, which costs tens of thousands of dollars annually.
The MS Societies of Canada and the US have tried to accommodate pressure
from the medical establishment while appeasing
patients by providing $2.4 million of support to seven small basic research projects over the next few years. However, the
paltry amount of funding and the focus on basic research has simply further raised the ire of the MS community. Not one of the
projects is focused on improving intervention techniques, and some of them, such as testing for similar conditions in the brains of
Alzheimer's patients, would appear to be aimed primarily at fortifying the arguments of detractors. In addition, some of the
projects appear to have been chosen because the researchers have not in the past worked with Dr. Zamboni, which might
seem logical, except that part of Dr. Zamboni's contribution was precisely in the area of techniques for the detection of venal
At this point, based on the evidence of thousands of case histories
and several scientific studies, the science points to a
cost/benefit trade off that is wildly on the positive for providing the treatment. The benefits would accrue not only to MS
patients but to society as a whole which needs otherwise to pay for their MS drugs and accommodate their incapacities. The
research at this point needs to focus on refining the technique. And despite how the mainstream media tries to depict it,
pressure from advocacy groups is being correctly aimed, not at short-circuiting the scientific method, but at overcoming the
intransigence of the medical establishment.
Philip Lillies is a community and labor activist, secretary to the Moncton
chapter of the Council of Canadians, secretary to the
Moncton District Labour Council, and vice-president for the Public Service Alliance of Canada to the New Brunswick
Federation of Labour. He lives in Moncton, New Brunswick, with his wife, Anne, who is afflicted with multiple sclerosis and is
on a waiting list for angioplasty at a treatment center in New York State.
The work of Dr. Paolo Zamboni in treating MS as a vascular disease is
a powerful reminder of the importance
of ensuring steady blood flow throughout the body.
For a summary of Dr. Zamboni's findings, please view:
Just in case you don't make it to the blog post above, here are the take-away points:
1. Excessive intake of sugar and other refined carbohydrates is
a primary cause of deterioration of
blood vessel walls. The mechanisms involved are many, and include increased blood viscosity and hyperinsulinemia.
2. Cheap vegetable oils that are high in polyunsaturated fatty
acids (safflower, sunflower, cottonseed, corn) tend
to be rich sources of free radicals that damage blood vessel walls.
3. A buildup of homocysteine can induce blood vessel damage. To
prevent homocysteine buildup, it's vital that
you ensure adequate intake of vitamins B12, B6, and folate.
Click here to learn about Homocysteine Care:
https://www.drbenkim.com/ sunshop/index.php?l=product_ detail&p=99
4. Chronic anger and anxiety can damage blood vessel walls through hypersympathetic activity.
5. Excessive intake of foods that are cooked at high temperatures
increases your exposure to free radicals
that can contribute to blood vessel damage.
ANOTHER SITE that discusses holistic cure: http://www.nhfw.info/multiple-sclerosis2.html
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