August, 2020

Political Science

By Michael J. Katin, MD

Cancer never sleeps. Except during COVID-19 restrictions, holidays, and while waiting for insurance authorization for treatment.

Many physicians have witness the bewilderment of patients who are highly trained in other disciplines, such as engineering and chemistry, who cannot fathom why the things we do are not totally evidence based and standardized. They're correct, of course. As our punishment, we are now subject to the randomness of measures to deal with the SARS-CoV-2 pandemic, not just in the United States but everywhere. Politicization of this crisis has occurred on a level never previously experienced. It is difficult to believe that there cannot be a consensus on the relative risk of activities versus isolation (where previously have healthy people been quarantined?), the value of wearing a mask, and even whether certain treatments are worth exploring when there's not a cure.

It has been obvious that the media are capable of covering only one story at a time, which is why columns like this one exist to enable presentation of information that will never be promoted by CNN, Fox News, Al Jazeera, or the Onion.

Once coverage of the impeachment trial of President Trump had concluded, attention was immediately turned to the pandemic. Medical journals were still being published and virtual conferences filled the internet. As with many discoveries in non-medical sciences, these were totally ignored by the media. In an attempt to finally achieve the purpose of moving past discussing SARS-Cov-2, here are a number of items that escaped notice over the past several months:

Infections and Alzheimer's Disease: still can't get away from pathogens. A review by Anthony Komaroff raised the disturbing possibility that many cases of Alzheimer's Disease can be set off by infections. For those of us for whom worrying about things in the short term isn't enough.

Trying to cure patients with metastatic disease: A flurry of articles dealing with aggressive treatment of patients with oligometastatic disease, usually using more frequent application of advanced but available radiation therapy techniques rather than fourth and fifth line systemic agents or hospice, and trying to turn some types of advanced cancer into chronic rather than fatal diseases.

CAR T-Cell Therapy: Looks as if it actually works! Durable responses in patients with relapsed or refractory mantle-cell lymphoma.

5,000 articles on Immunotherapy: Yes, we know. Even for advanced colorectal cancer. Who would have thought

Yogurt prevents lung cancer: Another blockbuster missed because of media tunnel vision. Twice, since it was an online release in October 24, 2019, in the midst of impeachment activity and published February , 2020, during the impeachment trial. Coverup by the anti-yogurt establishment?

Physician burnout is a major problem. Several articles, most prominently in the New England Journal, June 25. As long as doctors keep showing up, who cares? Nobody

In case you can't score any yogurt: Can cannabis cure cancer? ? Print version came out in March, appropriate to when cannabis sales were heading through the roof.

Trade-off for being able to treat oligometastatic disease: What's left to take away from the specialty of radiation oncology? The TARGET-A Randomized Clinical Trial in Early Breast Cancer indicated no significant decrease in mastectomy-free survival, distant disease-free survival, or overall survival, although an increase in local recurrence, when patients with early breast cancer are treated with delayed single-fraction intraoperative radiation therapy versus standard whole breast irradiation. Hypofractionation running wild.

BUT a cure for cancer may be on the horizon anyway: A last-minute entry to qualify for this column, from July 30, was a report that retinoic acid produced by malignant cells may corrupt tumor-associated macrophages to prevent their appropriate function. This may once and for all settle the question as to the relative risk versus benefit of dermatologic use of retinoic acid. Interestingly, a drug, mefloquine, used to treat malaria, works by interfering with retinoic acid metabolism. Maybe? And what other drug is used to treat malaria? A coincidence?

AND LAST BUT NOT FIRST: In the middle of all this confusion, the axion, a hypothetical dark matter particle, may have been detected for the first time by physicists at the XENOXIT detector in Italy (be honest -- you didn't even know this facility existed). This may be the foremost physics discovery of the century, but totally overlooked due to the controversies about whether masks should be worn at Wal-Mart and whether Lysol is more effective against SARS-CoV-2 if ingested or injected. Oh, and what to do with thousands of extra ventilators


Are Antibodies Going to Come Along (to the tune of "Is Anybody Going to San Antone"

Woke up this morning feeling kind of warm
And things don't taste the same
I read just enough to know there was a chance
That COVID-19 was to blame

Went to get a screening, got a swab up my nose
Don't want to have to feel that again
Said I'd get my reading in a week and a half
Guess I'm on my own 'til then.

Are antibodies going to come along
And save me from Corona?
Anytime I find out I'm positive
I'll be glad to be a donor.

Keeping on this mask is such a pain in the neck
Making me feel that I'm choking
But I'll do my best to wear it 'cause I value my health
I'll have it off just for drinking and smoking.

Are antibodies going to come along
And save me from Corona?
Anytime I find out I'm positive
I'll be glad to be a donor.

And now I find I'm not allowed to go back to work
Until I prove I'm not infected
Guess I'll spend the time just hanging out at the bar
As long as I don't get detected.

Are antibodies going to come along
And save me from Corona?
Anytime I find out I'm positive
I'll be glad to be a donor.

Asteroid JF1 Countdown: Asteroid JF1 will be impacting with or passing by Earth May 6, 2022, which, counting May 6, is 644 days from now. Plenty of time left to stock up on batteries, plywood, hand sanitizer, bubble wrap, and duct tape.