Tuesday, July 17, 2018

Do TCM doctors have a shorter life span than doctors of western medicine?

It's a common theme on the Internet of the Chinese language: "台湾中医比西医短命六七岁" (Taiwanese Traditional Chinese Medicine doctors have a shorter life span than doctors of western medicine by six to seven years). Like almost all popular articles written in Chinese, the source of claim is not verified. In this case, it's simply stated as "台湾《联合报》报道" (according to the report of Taiwanese United Daily News), or "根据台湾医学会最新调查" (according to the latest investigation of the Taiwanese Medical Society"), without giving a link.

After some Googling, I managed to locate the earliest webpage that carried this information. At blog.udn.com/giveman/4346332 posted at 2010/08/23 15:08, the blogger attributed this claim to the Taiwanese 衛生署 (Ministry of Health) and 婦產科醫學會 (Taiwanese Gynecological Society) by quoting a reporter by the name of 陳惠惠. Unfortunately, there's no further link. One week later, on 2010/8/30, Professor 黃文璋 (Wen-Jang Huang) of National University of Kaohsiung wrote that "雖未能找到台灣婦產科醫學會的調查報告,但在網路上查到..." (Although the investigative report by the Taiwanese Gynecological Society was not found, I searched and found on the Internet that ..."

Literature search aside, the fact that a statement claiming that TCM doctors live shorter than non-TCM counterparts can quickly become popular and continue floating on the Internet for many years is an interesting one. Indeed, TCM is said to be strong at 养生 (maintaining health) and not so at medical treatment, as most people believe. Then, why would TCM practitioners themselves die younger? If that turns out to be true based on quality statistics, there may be one factor at play: TCM doctors are not fully appreciative of the toxicity of some ingredients (they know but choose to make light of them), or have not kept abreast of some latest studies (as in the case of 马兜铃酸 or aristolochic acid found to exist in much more herbs than previously thought).

Sunday, March 11, 2018

Better be fat, if you're a man with cancer

"Obesity associated with longer survival for men with metastatic melanoma"

"Obese patients with metastatic melanoma (note: the most dangerous type of skin cancer) who are treated with targeted or immune therapies live significantly longer than those with a normal body mass index... This effect, referred to as the 'Obesity Paradox', principally manifested itself in men... The researchers found no significant differences in survival between women with normal, overweight or obese BMI... Women with metastatic melanoma have long been known to have better outcomes compared to men. In this study obesity overcame that survival disadvantage for men, leading researchers to now look at the possible impact of sex hormones in this effect... Recent studies have shown a similar survival benefit for obese patients with colorectal or kidney cancer."

The researcher, Dr. Jennifer McQuade at M. D. Anderson Cancer Center, consistently rated the best cancer hospital in the US, said, “The public health message is not that obesity is good. Obesity is a proven risk factor for many diseases,... Even within our metastatic melanoma population, we would not suggest that patients intentionally gain weight. We need to figure out what is driving this paradox and learn how to use this information to benefit all of our patients.”

Nevertheless, the temptation for a male cancer patient in this situation to gain weight is so strong that the politically correct public health message could be ignored. Unless the cause of this "Obesity Paradox" is soon identified, it may be wise to advise these patients to try temporarily accumulating body fat in order to improve survival. Obesity is no doubt an evil. But what evil is more bad than cancer? The researcher in this study is reluctant to advocate weight gain even in this very specific case. That is understandable as they are neither interested nor specialized in making an exception to the overall healthy advice.