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Interesting article about potential low-cost effective cancer treatments that Big Pharma is not researching because there is no profit in it for them. From Pacific Standard:

The War on Cancer: Big Pharma Is Keeping Us From Developing Low-Cost Treatments

Big Pharma’s focus on blockbuster cancer drugs squeezes out research into potential treatments that are more affordable. Says one researcher: “What is scientific and sexy is driven by what can be monetized.”

Numerous laboratory, animal, and small human studies suggest that low-dose, continuous chemotherapy holds promise in shrinking tumors and preventing cancer’s recurrence. But the next step—testing what Retsky did in a large-scale clinical trial—is a long shot given the way cancer treatments are developed today.

Take Michelle Holmes, an associate professor of medicine at Harvard Medical School. She’s been trying for years to raise money for trials on the effects of aspirin on breast cancer. Animal studies, in vitro experiments, and analysis of patient outcomes suggest that aspirin might help inhibit breast cancer from spreading. Yet even her peers on scientific advisory boards appear uninterested, she says. “For some reason a drug that could be patented would get a randomized trial, but aspirin, which has amazing properties, goes unexplored because it’s 99 cents at CVS,” says Holmes.

Increasingly, Big Pharma is betting on new blockbuster cancer drugs that cost billions to develop and can be sold for thousands of dollars a dose. In 2010, each of the top 10 cancer drugs topped more than $1 billion in sales, according to Campbell Alliance, a health-care consulting firm. A decade earlier, only two of them did. Left behind are low-cost alternatives—therapies like Retsky’s or existing off-label medications, including generics—that have shown some merit but don’t have enough profit potential for drug companies to invest in researching them.

The newer drugs have in some cases shown dramatic life-extending results for patients. Yet cancer remains the second-most-common cause of death in the U.S. after heart disease, killing about 580,000 people a year. Worldwide, 60 percent of all cancer deaths occur in developing countries, where experts say the incidence of the disease is growing rapidly, as is a desperate need for affordable care. That has added urgency to an active debate about whether efforts to combat cancer—and where to put scarce research dollars—need to be rethought.

Sukhatme and his wife Vidula, an epidemiologist, are among those trying to do something about it. They have spearheaded a new non-profit,  Global Cures, to promote alternative treatments that are unlikely to attract commercial interest from drug companies. Global Cures calls these forsaken therapies “financial orphans". To help patients and their doctors, the non-profit is producing reports that explain the science behind promising orphan therapies—those that have shown merit in animal studies and limited human data. And Global Cures also has set itself a more challenging goal—to find the money for clinical trials.

Creating an innovative new drug—including everything from early research to late stage trials—costs on average of $1.3 billion, according to the Tufts Center for the Study of Drug Development. Nonetheless, drug development in the United States, even when it is funded in part by taxpayer dollars and encouraged by federal bureaucracies, isn’t geared toward inexpensive alternative treatments.

The NIH, particularly through the National Cancer Institute, contributes to about 15 percent of all clinical trials related to cancer, but the amount it gives is in decline. The agency instead partners with pharmaceutical companies or academic institutions, and the trials the NCI does support usually are for new drugs, not for re-purposing existing ones. 

Low-cost alternatives like aspirin must fight for consideration within a scientific community that is producing effective cancer drugs that can command $100,000 or more for a course of treatment. The escalating prices for these drugs worry many involved in the fight against cancer. Some of the new drugs will eventually be used in combination, a step that could push cost of treatment into the hundreds of thousands, says Lichter.

Since myopia increased 66% between the early 1970s to early 2000s in the United States, it is thought that there are environmental factors at play, namely higher levels of education, all our close-up activities with new technology (reading, computers, tablets, etc.) straining our eyes, and spending too much time indoors. From The Atlantic:

Nearsightedness and the Indoor Life

Over the past 15 years, the world has witnessed an explosion of cases of myopia, or nearsightedness. A quarter of the world's population, or 1.6 billion people, now suffer from some form of myopia, according to the Myopia Institute. If unchecked, those numbers are estimated to reach one-third of the world's population by 2020. 

The 2009 study is hardly the first to suggest that an increase in years of formal education and access to technology across society may account for higher myopia rates in recent years. Ophthalmologists and optometrists have cautioned that close-up activities like reading and using computers, tablets, and smartphones interfere with normal blinking and put a strain on the eyes. When abused, they can lead to double vision, myopia, and serious conditions such as retinal detachment and vision loss. The overuse of handheld electronics such as iPads and tablets by young children is especially worrisome, since their eyes are still developing and are more likely to be affected, according to researchers.

Kathryn Rose, a researcher of visual disorders at the University of Sydney's college of health sciences, recently concluded  that spending too much time indoors also has a huge impact on eyesight deterioration. Rose said in a CNN interview that she was not sure how time spent using digital media relates to myopia progress, but that outdoor light has been shown to have a positive effect on vision. Studies from the U.S., Singapore, and China confirm a link between the time spent outdoors and the prevention of myopia, Rose said. However, both the level of light and the duration of exposure to outdoor light must reach a certain threshold to have a preventive effect, according to one of her studies. Spending at least 10 to 14 hours outside per week may prevent the early onset of myopia, she concluded.

Dr. Maria Liu, head of the Myopia Control Clinic that opened last year, explained that prevention and treatment success depend on early detection. Nearsighted children under 10 could benefit the most from intervention. This age group is also the most susceptible to eye damage from prolonged use of visual media, according to the myopia specialist."The eyeballs are very adaptive while they are developing," Liu told me. "If we impose a lot of near work on the eyes as they are developing, the eyes will interpret nearsightedness as being the normal state."

She explained the rise in myopia prevalence is likely caused by a shift in lifestyle from spending time outdoors to an indoor-oriented existence. Electronic devices play a major role in this shift, especially with young children being introduced to technology at an earlier stage in their life, and using handheld devices that require a smaller working distance than that for a physical book or television.

The Myopia Control Clinic specialists use corrective lenses (novel contact lenses) to slow down myopia in children. If applied early enough, corrective lenses have proven effective in treating the disorder. In cases with very high myopia progression, however, scleral reinforcement surgery is used to reduce or stop further damage caused by high myopia, which often can be degenerative. Atropine is the only drug that so far has proven effective in slowing myopia progression. The drug is used as a second line of treatment after all optical treatments fail.

Although modern lifestyle makes it harder to fight the disorder, there is something parents can do to prevent its early onset."Whether it is because hormonal levels are different outdoors, or because the light intensity is stronger, or because we do less close-up work, it has been shown consistently that outdoor activity is very protective and tends to slow the rate of progression."

Taking frequent 10-minute breaks from near-work and looking in the distance is also recommended, including for young adults who spend a lot of time working on computers or laptops and may suffer from accommodating spasms that cause blurry distance vision and dry eyes. Some specialists recommend limiting time in front of computers, TVs, and handheld devices to 1.5 hours a day, especially for young children.

This study was done on mice, but it would be great if it also holds true for human eyes. Another benefit from daily drinking of coffee! From Science Daily:

A cup of coffee a day may keep retinal damage away, study shows

Aside from java's energy jolt, food scientists say you may reap another health benefit from a daily cup of joe: prevention of deteriorating eyesight and possible blindness from retinal degeneration due to glaucoma, aging and diabetes.

Raw coffee is, on average, just 1 percent caffeine, but it contains 7 to 9 percent chlorogenic acid (CLA), a strong antioxidant that prevents retinal degeneration in mice, according to a Cornell study published in theJournal of Agricultural and Food Chemistry (December 2013).

The retina is a thin tissue layer on the inside, back wall of the eye with millions of light-sensitive cells and other nerve cells that receive and organize visual information. It is also one of the most metabolically active tissues, demanding high levels of oxygen and making it prone to oxidative stress. The lack of oxygen and production of free radicals leads to tissue damage and loss of sight.

In the study, mice eyes were treated with nitric oxide, which creates oxidative stress and free radicals, leading to retinal degeneration, but mice pretreated with CLA developed no retinal damage.

Previous studies have shown that coffee also cuts the risk of such chronic diseases as Parkinson's, prostate cancer, diabetes, Alzheimer's and age-related cognitive declines.

Excellent reason to enjoy coffee every day. From Science Daily:

Increasing consumption of coffee associated with reduced risk of type 2 diabetes, study finds

New research published in Diabetologia (the journal of the European Association for the Study of Diabetes) shows that increasing coffee consumption by on average one and half cups per day (approx 360ml) over a four-year period reduces the risk of type 2 diabetes by 11%. 

The authors examined the associations between 4-year changes in coffee and tea consumption and risk of type 2 diabetes in the subsequent 4 years.

The authors used observational data from three large prospective, US-based studies in their analysis: the Nurses' Health Study (NHS) (female nurses aged 30-55 years, 1986-2006), the NHS II (younger female nurses aged 25-42 years 1991-2007), and the Health Professionals Follow-up Study (HPFS) (male professionals 40-75 years, 1986-2006). The final analysis included 48,464 women in NHS, 47,510 women in the NHS II, and 27,759 men in HPFS.

The authors documented 7,269 incident type 2 diabetes cases, and found that participants who increased their coffee consumption by more than 1 cup/day (median change=1.69 cups/day) over a 4-year period had a 11% lower risk of type 2 diabetes in the subsequent 4-years compared to those who made no changes in consumption. Participants who decreased their coffee intake by 1 cup a day or more (median change=-2 cups/day) had a 17% higher risk for type 2 diabetes. Changes in tea consumption were not associated with type 2 diabetes risk.

Those with highest coffee consumption and who maintained that consumption -- referred to as "high-stable consumers" since they consumed 3 cups or more per day -- had the lowest risk of type 2 diabetes, 37% lower than the "low-stable consumers" who consumed 1 cup or less per day.

While baseline decaffeinated coffee consumption was associated with a lower type 2 diabetes risk, the changes in decaffeinated coffee consumption did not change this risk. 

More studies on the amazing benefits of exercise, or activity, even light activity.  From Science Daily:

Simple tests of physical capability in midlife linked with survival

Low levels of physical capability (in particular weak grip strength, slow chair rise speed and poor standing balance performance) in midlife can indicate poorer chances of survival over the next 13 years, while greater time spent in light intensity physical activity each day is linked to a reduced risk of developing disability in adults with or at risk of developing knee osteoarthritis, suggest two papers published on bmj.com today.

The researchers conclude that there are "robust associations of standing balance time, chair rise speed and grip strength at age 53 with all-cause mortality rates over 13 years of follow-up." They suggest there is value in using these simple tests to assess physical capability in midlife to identify those people who are less likely to achieve a "long and healthy life."

In a linked paper, a team of US researchers set out to investigate whether time spent in light intensity physical activity is related to a reduced risk of developing disability and disability progression.

Their study involved 1,680 men and women aged 49-83 years free of disability, but with or at high risk for developing knee osteoarthritis, a major disability risk factor. The primary outcome was the development of disability at a two-year follow up visit. In total, participants averaged 245 minutes/day of non-sedentary activity, of which the vast majority was light intensity activities (229 minutes/day).

The results show a "significant and consistent relationship between greater time spent in light intensity activity and a reduced risk of developing disability or progression in disability," say the authors.

More details on the second study. From Science Daily:

Light activity every day keeps disability at bay

More research on the benefits of exercise. From Science Daily:

Road to fountain of youth paved with fast food ... and sneakers? Exercise may prevent or delay fundamental process of aging

We all know that too much food combined with too little exercise can add up to poor health and disease. But overeating and inactivity also speed up the aging process, right down to our cells. At the end of a cell's lifespan, a process called senescence kicks in -- cells lose the ability to divide and begin to secrete substances that damage the surrounding cells. While unhealthy lifestyle habits can accelerate this process, researchers at the Mayo Clinic wanted to know if increased exercise could counteract it. 

The research team compared mice fed a fast food diet (FFD) for 5 months with those fed a standard chow diet (control). Unlike the controls, the FFD mice developed insulin sensitivity, impaired glucose tolerance, impaired exercise ability, and heart dysfunction. But when the FFD mice were given a running wheel, the exercise began to counteract the effects of a poor diet. White et al. observed a number of improvements including body weight, metabolism, and cardiac function. They also saw a significant decrease in signs of cell senescence and associated inflammation.

"Our data clearly show that poor nutritional choices dramatically accelerate the accumulation of senescent cells, and for the first time, that exercise can prevent or delay this fundamental process of aging. 

Another reason to wash your hands before handling food. From The Scientist:

Money Microbiome

Analyzing the genetic material on 80 $1 bills sampled from a Manhattan bank, researchers from New York University (NYU) have discovered a diverse array of microbes, most of which are relatively harmless to humans, but a few that may leave you washing your hands after every cash transaction. It total, they found more than 3,000 bacterial types, including some drug-resistant species, and known microbes accounted for just 20 percent of the non-human DNA the researchers isolated; the rest belongs to as-yet unidentified species.

The most abundant species the researchers identified were those that cause acne, followed by benign skin flora. More alarming discoveries included pathogenic Staphylococcus species as well as bacteria associated with gastric ulcers, pneumonia, and food poisoning. The researchers also found DNA from antibiotic-resistance genes, such as those carried by the deadly methicillin-resistantStaphylococcus aureus (MRSA).

The researchers even found evidence of anthrax, although Carlton notes this shouldn’t necessarily be cause for concern. “Anthrax is a very common bacteria in soil."

Nevertheless, the microbial diversity identified highlights the likelihood that cash—one of the most common items to be distributed internationally—could spread disease around the world.2010 study that investigated currencies from 10 different countries, including Australia, China, the U.K., Ireland, Mexico, and the U.S., found similarly dirty money, and the authors recommended “that current guidelines as they apply in most countries with regard to the concurrent hygienic handling of foods and money should be universally adopted.”

Flatulence is good, and up to 18 a day is totally normal! From NPR:

Got Gas? It Could Mean You've Got Healthy Gut Microbes

We know that air often comes after eating nutrient-packed vegetables, such as cabbage, kale and broccoli. And researchers have found that fiber-rich foods, like beans and lentils, boost the levels of beneficial gut bacteria after only a few days, as we reported in December.

So all this got us wondering: Could passing gas, in some instances, be a sign that our gut microbes are busy keeping us healthyAbsolutely, says Purna Kashyap, a gastroenterologist at the Mayo Clinic in Rochester, Minn. "Eating foods that cause gas is the only way for the microbes in the gut to get nutrients," he says. "If we didn't feed them carbohydrates, it would be harder for them to live in our gut."

And we need to keep these colon-dwelling critters content, Kashyap says. When they gobble up food — and create gas — they also make molecules that boost the immune system, protect the lining of the intestine and prevent infections.

"A healthy individual can have up to 18 flatulences per day and be perfectly normal," he adds.

Gas gets into the digestive tract primarily through  two routes: Swallowing air (which we all do when we eat and chew gum) and your microbiome. That's the collection of organisms in the GI tract that scientists and doctors are currently all fired up about. (Check our colleague Rob Stein's recent series on it.) That microbiome includes hundreds of different bacteria. But there are also organisms from another kingdom shacking up with them: the archaea.

All these microbes are gas-making fools. They eat up unused food in your large intestine, like fiber and other carbohydrates we don't digest, and churn out a bunch of gases as waste. But that's not all they make. They also produce a slew of molecules (called short chain fatty acids) that may promote the growth of other beneficial bacteria and archaea.

And the more fiber you feed these friendly inhabitants, the more types of species appear, studies have found. "Undigested carbohydrates allow the whole ecosystem to thrive and flourish," Kashyap says. Most gas made by the microbiome is odorless. It's simply carbon dioxide, hydrogen or methane. But sometimes a little sulfur slips in there."That's when it gets smelly," Kashyap says.

But here's the hitch: Many of the smelly sulfur compounds in vegetables have healthful properties. Take for instance, the broccoli, mustard and cabbage family. These Brassica vegetables are packed with a sulfur compound, called sulforaphane, that is strongly associated with a reduced risk of cancer. Another possible benefit of a little smelly gas? It may reduce the total volume of air in the gut, Kashyap says. 

This study suggests another reason to avoid Triclosan. From Science Daily:

In lab tests, the antimicrobial ingredient triclosan spurs growth of breast cancer cells

Some manufacturers are turning away from using triclosan as an antimicrobial ingredient in soaps, toothpastes and other products over health concerns. And now scientists are reporting new evidence that appears to support these worries. Their study, published in the ACS journal Chemical Research in Toxicology, found that triclosan, as well as another commercial substance called octylphenol, promoted the growth of human breast cancer cells in lab dishes and breast cancer tumors in mice.

Kyung-Chul Choi and colleagues note that hormonal imbalances seem to play a role in the development of breast cancer. Given that link, researchers are investigating whether endocrine-disrupting chemicals (EDCs), which are compounds that act like hormones, might spur cancer cell growth. EDCs have become ubiquitous in products, in the environment and even in our bodies. Research has found that two EDCs -- triclosan, an antimicrobial ingredient in many products, including soaps, cosmetics and cutting boards; and octylphenol, which is in some paints, pesticides and plastics -- have accumulated in the environment. Additionally, triclosan is reportedly in the urine of an estimated 75 percent of Americans. Choi's team wanted to see what effect the two compounds have on breast cancer cells.

In tests on human breast cancer cells and in special immunodeficient mice with tissue grafts, the scientists found that both agents interfered with genes involved with breast cancer cell growth, resulting in more cancer cells. Mice that were exposed to the two compounds had larger and denser breast cancer tumors than the control group. "Although the doses of EDCs were somewhat high, we did this to simulate their effects of daily exposure, as well as body accumulation due to long-term exposure, simultaneously in animal experiments," said Choi. "Thus, exposure to EDCs may significantly increase the risk of breast cancer development and adversely affect human health," the researchers state in the paper.

Excerpts from a very interesting NPR interview with Dr. Martin Blaser and his views on the human microbiome. His recently published book is Missing Microbes: How the Overuse of Antibiotics is Fueling Our Modern Plagues. From NPR News:

Modern Medicine May Not Be Doing Your Microbiome Any Favors

There are lots of theories about why food allergies, asthma, celiac disease and intestinal disorders like Crohn's disease have been on the rise. Dr. Martin Blaser speculates that it may be connected to the overuse of antibiotics, which has resulted in killing off strains of bacteria that typically live in the gut.

Blaser is an expert on the human microbiome, which is the collection of bacteria, viruses, fungi and other microbes that live in and on the body. In fact, up to 90 percent of all the cells in the human body aren't human at all — they're micro-organisms. Blaser is the director of NYU's Human Microbiome Program and a former chairman of medicine there. His new book is called Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues.

"Since World War II, we've seen big rises in a number of diseases: asthma, allergies, food allergies, wheat allergy, juvenile diabetes, obesity. ... These are all diseases that have gone up dramatically in the last 50 or 70 years. One of the questions is: Why are they going up? Are they going up for 10 different reasons, or perhaps there is one reason that is fueling all of them."

"My theory is that the one reason is the changing microbiome; that we evolved a certain stable situation with our microbiome and with the modern advances of modern life, including modern medical practices, we have been disrupting the microbiome. And there's evidence for that, especially early in life, and it's changing how our children develop."

"There's a choreography; there's a normal developmental cycle of the microbiome from birth over the first few years of life, especially the first three years, [that] appear[s] to be the most important. And that's how nature has, how we have, evolved together so that we can maximize health and create a new generation, which is nature's great purpose. And because of modern practices, we have disrupted that. And then the question is: Does that have consequence[s]?"

"As far as we know, when the baby is inside the womb it is apparently sterile. ... The big moment of truth is when the membranes rupture, the water breaks, and the baby starts coming out. And that's where they first get exposed to the bacteria of the world, and the first bacteria they're exposed to is their mother's bacteria in the birth canal. So as labor proceeds, the babies are in contact with the microbes lining their mother's vagina and, as they're going out, they're covered by these bacteria. They swallow the bacteria; it's on their skin. ..."

"That's their initial exposure to the world of bacteria. That's how mammals have been doing it for the last 150 million years, whether they're dolphins or elephants or humans. ... And we know a little about what those bacteria are. The most common bacteria are lactobacillus and there's evidence that over the course of pregnancy the microbiome in the vagina changes, just as many other parts of the body are changing. The microbiome is changing in its composition in terms of maximizing lactobacilli, and these are bacteria that eat lactose, which is the main component of milk. So the baby's mouth is filled with lactobacilli. The first thing that happens is they go up against their mom's breast and they inoculate the nipple with lactobacilli and now milk and lactobacilli go into the new baby and that's the foundation for their microbiome and that's how they start their life. ..."

"You could project that if they didn't acquire these organisms or they didn't acquire them normally or at the normal time, then the foundations might be a little shaky."

"Shortly after birth, they compared the microbiomes in the babies that came out. The babies that were born vaginally, their microbiome, not surprisingly, looked like the mom's vagina everywhere in the body — in their GI tract, on their skin, in their mouth. But the babies born by C-section, their microbiome looked like skin and it didn't even necessarily look like the mom's skin, maybe it was somebody else in the operating room. So it's clear that the microbiome is different immediately depending on the kind of birth."

"What I can tell you is that our immune system is quite complex. There are many kinds of immune cells. There are cells that strongly recognize foreign substances, there are ones that try to damp [the immune system] and down-regulate it. There's what we call innate immunity, which is the immunity we're all born with, and then there's adaptive immunity — the immunity that develops when we experience different kinds of exposures. So it's very complex."

"There are many different probiotics.  I think I can say three things: The first is that they're almost completely unregulated; second is that they seem to be generally safe; and third is that they're mostly untested. ... I'm actually a big believer in probiotics; I think that's going to be part of the future of medicine, that we're going to understand the science of the microbiome well enough so that we can look at a sample from a child and say this child is lacking such-and-such an organism and now we're going to take it off the shelf and we're going to give it back to that child. ... "