Andrew Dodgshun

Paul, I respect your dedication and optimism.  Nothing at all bad can come from your venture, provided you don’t start advertising your services as an alternative to proven treatment in children who can be cured.  We can agree to disagree on the stated final outcome of your idea but since it will undoubtedly have fantastic knock-on effects in other areas of health I fully support it.

I heard something very wise from a friend last night that I think is very applicable here - “We can sit with difference and still be in unity”.

paul wheaton wrote:Andrew,

Did you see "The Food Cure"?

I haven’t watched the film but I am very familiar with the Gerson protocol.  I’ve come across all sorts of things in my time in paediatric oncology.  Gerson, alkaline diet, fasting, intermittent fasting, macrobiotic, vegan, multivitamins, garlic, megadose vitamin C, aromatherapy etc etc etc.

I have had a number of patients where there were no more conventional options for cure pursue these things.  Every one died.  Every.  One.  Not one patient I have been involved with has done the Gerson protocol and lived.  There’s also an increasing literature around treatment abandonment to pursue these things.  Again the numbers are shocking.  Patients with curable cancers die for lack of appropriate therapy.

Again I want to reiterate - food is medicine.  What we put in our bodies and what we do with our bodies (activity) has FAR more impact on our health and mortality than anything else.  Including medications.  But cancer is one of those situations where you have a rogue series of cells which simply will not go away with supplements or food-based cures.  We have the luxury in paediatric oncology of boasting about an overall 85% cure rate for all cancers.  That’s a totally different kettle of fish to adult cancers.  I absolutely understand why an adult would choose not undergo chemotherapy that can offer no chance of cure, just prolonging of life at the cost of quality.  But in paeds we are in a different scenario.  I love nothing more than discharging a patient, cancer free, cured, with little to no late effects from the therapy they’ve received.  No dietary therapy can achieve that.

Flora Eerschay wrote:

Andrew Dodgshun wrote:By the way I am the real deal!

There is a children's hospital near me, and yesterday they announced that they cured one boy from leucemia by giving him his own cells, but genetically modified (it's called CAR-T and I probably can't explain it properly...). They say that he wouldn't make it otherwise because he wasn't responding to normal treatment. He's 11 years old and they're expecting him to be completely healthy.
I'm thinking of the social ethics of permaculture - "people care" etc. I'm sure the children and parents are already getting professional psychological support nowadays, but when I had a serious surgery at 12, there was no such thing. In fact, other kids in the hospital were scaring each other by telling stories about ghosts and who will die when. The kids generally seemed less concerned about it than their parents.

CAR-T is pretty incredible therapy.  It’s forcing the immune system to recognise the cancer cells as foreign and attack them.  It’s promising for leukaemia in particular but it’s riotously expensive.  To your second point, yes we have wrap around services including play specialist (child life specialists in the US), teachers, psychologists, social work, physio, OT, nursing and medical.  It’s a vastly different experience to the bad old days!

Such a great conversation, and a really important one.  Great to chat with you Paul and others.

Firstly regarding your point about cancer and the immune system Paul.  What you said is not quite accurate.  It is true that when cells divide mistakes are made.  We have 2 systems to pick them up immediately - the proofreading domain in the DNA polymerase and the mismatch repair system.  If they fail and a mutation slips through there are a number of secondary mechanisms to protect the organism (us) against deleterious effects of the mutation.  Many mutations don’t matter, don’t affect the function of the protein or there’s enough buffer in the system to get on with the job without the use of that copy of the gene.  Many mutations simply cause the cell to die because it can’t function but another cell comes along to take its place.  The rare mutation in a critical gene that causes a cell not to die but to proliferate and lose control is a problem.  There are cellular systems to detect this and cause apoptosis (programmed cell death) to ensure the organism comes to no harm.  The immune system probably plays a role in surveillance for this but is not the major player.  Cancer by definition is when a mutation in a cell has evaded ALL of these systems.  By the time you get to this point you have cancer and no immune function can rescue you.  I note there are some exceptions to this is some forms of cancer but this is the rule for most.  There are some indolent forms of cancer which we “live with”, a significant minority of men in their 70s have indolent prostate cancer that never causes a problem.  But it’s not the immune system keeping it in check, it’s the biology of the cancer itself.

Secondly regarding Billy.  I want to make clear that although I don’t believe environmental exposures are a major CAUSE of childhood cancer I do believe environment has a huge amount to do with recovery.  Billy should go stay with his permie aunt, he’ll do better with proper nutrition and environment to support his recovery during treatment.  I don’t believe that nutrition and environment will cure his cancer (I know other folks here will disagree but that’s my strong belief) but it certainly will support his recovery during and after treatment.  Not because of carcinogens or lack of per se but just in terms of giving the body what it needs to recover.  There are some studies looking at cure rates from childhood cancer in light of nutrition but they’re very crude - underweight, healthy weight, overweight.  They show that under and over weight lead to poorer recovery.  Many parents believe that gross freeze dried powdered vitamins make a difference but I don’t think they do and no evidence has said they do.

Regarding the Amish - I know they’re not a permie equivalent but there is good research on their population through time.  My point is that they have vastly reduced rates of adult cancer indicating their environment is altering the risk of environmentally-associated diseases in a positive way.  If childhood cancer was also due to exposures you would expect that risk to be lowered also.

Regarding your final point - I love your idea and I think it’s worth pursuing.  I don’t think it will affect the incidence of childhood cancer but it sure may affect the quality of recovery.  And even if it doesn’t you’ll definitely affect the rates of other diseases down the track which is actually a much larger impact - heart disease, stroke and adult cancer.

paul wheaton wrote:Andrew, as much as I am constantly dogged by anonymous heroin addicts pretending to be all sorts of things and challenging me, I'm going to assume you are the real deal.

I wish to challenge you on a few fronts, but for the moment let's start with just one:   please help me to understand the relationship between toxins that the parents encounter before conception or during pregnancy and childhood cancer.

Great question. A longitudinal risk factor like the one you proposed is the hardest to disprove.  I honestly can’t hand-on-heart say that it definitely doesn’t have an impact - my gut says it’s not a major player for childhood cancer.  You would expect to see fluctuation by lifestyle and community.  A great example is the Amish.  They are at significantly lower risk of asthma due to lifestyle factors and exposures (more exposure to bugs, less exposure to pollutants).  They’re also at a significantly reduced (like 60%) risk of many types of adult cancers because of the way they live.  Yet their childhood cancer rate isn’t significantly different, or at least nobody has published that it is.

My closer-to-home example is in New Zealand where I live.  We look after children from urban and rural backgrounds, encompassing a wide range of lifestyles.  We look after children of people who have eaten organic food for decades, live rurally among like minded people and never take medication of any kind.  We look after children whose families only eat processed food, have exposure to legal and illegal drugs since day dot.  Our regional rates for childhood cancer are identical across these wildly different communities.

I mentioned about exposure to infectious agents in the last post.  It was based on this research which is worth a read.  https://www.sciencedaily.com/releases/2018/05/180521131746.htm

By the way I am the real deal!

Hi Paul,

I rarely post but often read these forums.  I feel like I have to speak up here because this is right in my wheelhouse.  I'm a paediatric oncologist and proud permie.  My day job is caring for children with cancer and their families with diagnosis, treatment and aftercare and I'm passionate about what I do.  I hear your heart in wanting to help these kids because it's in my heart too, and I also love your master plan and mission.  My concern is in the assertion that childhood cancer is caused by carcinogens when 95% of the time it is not.

You're totally right in that the majority of adult cancers are related to exposures both known and unknown to carcinogens - chemical, radiation, dietary, lack (of exercise particularly).  Childhood cancer is not.  It is primary a genetic disease in that usually it stems from a single genetic mistake in the reproduction of rapidly dividing cells early in life.  We know this is true for several reasons.  Firstly the types of cancers children get do not tend to be epithelial cells (skin, lining of bowel, mouth etc).  They tend to be in developing or growing cells and organs - kidney, liver, brain, bone marrow.  Childhood cancer is also not a disease of multiply accrued mutations over time leading from healthy cells to dysplastic cells to adenoma to carcinoma.  They tend to harbor few mutations but in predictable genes, often at predictable sites.  We also know that as much as 10% of childhood cancer is linked to variant alleles in risk genes which are present in all the child's cells.  RB1 mutations leading to retinoblastoma, NF1 mutations leading to optic pathway glioma, TP53 mutations in many malignancies, PMS2/MSH2 mutations in high grade glioma.

Many studies have looked at environmental factors in the development of childhood cancer and there is little to link them.  The most well proven exposure to correlate is that lack of exposure to bugs in early life may be linked to a modestly increased risk of acute lymphoblastic leukaemia in susceptible individuals.

Your statement about proliferation in paediatric oncology is true, but the reason is not what you think.  70 years ago paediatric oncology wasn't a specialty.  Why not?  Because all children died.  They attended the hospital with their leukaemia, were told the diagnosis and sent home for palliation.  At that time there was no treatment, nor did people think there would ever be treatment.  Now when a child attends hospital with a new acute lymphoblastic leukaemia we can offer an over 90% prognosis, often with minimal late effects.  As treatments are advancing we are offering treatment in more and more situations where before no treatment existed.  That's why paediatric oncology centres are bigger and busier.  There probably is a rise in diagnoses over time, but it is modest, not dramatic.

Respect to you and your mission, but had to correct this misunderstanding.
Sincerely,
Andrew

Hi everyone, this is my first post on permies but I've been following for a while.

I'm a paediatric oncologist so I am extremely concerned about antibiotic resistance. We regularly treat children with life threatening infections where, once the antibiotics don't work any more, children will die. I absolutely agree that antibiotics are overprescribed in so many situations
- viral upper respiratory tract infections (ie cold and flu)
- woulds/burns with only minor surrounding infection
- as artificial growth promotants in animals
- ear infections in children (look at the evidence!)

And even where antibiotics are required to save life or reduce suffering doctors often prescribe far broader spectrum than is necessary.

The key for me is reducing inappropriate prescibing and reducing spectrum if feasible where prescibing is necessary. Now I'm sure Marjory will be sensible in this video in explaining that natural remedies are not always appropriate. If you have necrotising fasciitis, you cannot use natural remedies and expect to live. In the pre-antibiotic era millions of people died of infections that natural remedies would be insufficient to treat. Provided she doesn't advocate for using these remedies in all cases and never visiting your doctor, then I have no issue.

Here's a non-infectious example of when such a recommendation was followed: https://www.nzma.org.nz/journal/read-the-journal/all-issues/2010-2019/2010/vol-123-no-1312/cc-mistry

The body is remarkable at healing itself in most situations. If natural remedies might support that process then all power to you. I would just caution that it has limits!