From the Conversation|Let’s treat the social causes of illness rather than just disease

The ‘Conversation’ today 1 October 2013 – re blogged by Grace Gawler: Let’s treat the social causes of illness rather than just disease. Fiona Stanley is the director of this year’s Melbourne Festival of Ideas: The Art and Science of Wellbeing, which opens today and continues until October 6, 2013. She is a Perinatal and pediatric epidemiologist; founding director and patron of the Telethon Institute for Child Health Research and a distinguished professorial fellow at University of Western Australia.

Authored by Fiona Stanley and Published in the ‘Conversation’ today 1 October 2013 – re blogged by Grace Gawler.

Fiona Stanley is the director of this year’s Melbourne Festival of Ideas: The Art and Science of Wellbeing, which opens today and continues until October 6, 2013.

Perinatal and pediatric epidemiologist; founding director and patron of the Telethon Institute for Child Health Research; distinguished professorial fellow at University of Western Australia

Let’s treat the social causes of illness rather than just disease

By Fiona Stanley, University of Western Australia

Fiona Stanley is the director of this year’s Melbourne Festival of Ideas: The Art and Science of Wellbeing, which opens today and continues until October 6, 2013.

Here she explains the ethos behind the Festival’s program.

Diseases are complex and their causes myriad. A relatively new field of research known as the “social determinants of health” shows that merely treating illness is not the best approach to what ails us, we need a comprehensive overhaul of what we are doing and to address underlying social mechanisms that harm well-being.

My medical training in the 1970s focused on the diagnosis and treatment of diseases – it rarely addressed the question of why people got them.

But as a young doctor working in child health, particularly with Aboriginal children, it became obvious to me that prevention of disease was by far the best way to practice medicine; it’s more humane and definitely more cost-effective.

In 1972, I left Australia to study epidemiology and public health in the United Kingdom and then the United States, where these disciplines were well advanced. I learnt of the limitations of modern medicine, that prevention was the key to health and that many diseases commenced in social adversity.

The most exciting thing for me was that it was also the beginning of the push for disease registers, large population data sets and data linkage – all skills I brought back to Australia. Continue reading “From the Conversation|Let’s treat the social causes of illness rather than just disease”

Cancer and the Global Equity Divide: A Call for Action Grace Gawler republished from The Conversation

Published with permission in The Conversation 4 February 2013 – please read & distribute this important information.

Cancer and the Global Equity Divide: A Call for Action.

By Alessandro R Demaio, University of Copenhagen

This article was written by Toni Kuguru, Sebastian Rodríguez Llamazares, Alessandro Demaio and A/Prof Felicia Knaul.

This year more than half of the nearly 13 million new cancer cases diagnosed worldwide and two-thirds of cancer deaths will occur in the world’s low and middle income countries (LMICs). Nearly a third of these deaths could have been prevented with the knowledge and technology already available today. For example, only 10% of children diagnosed with leukemia in the 25 poorest countries of the world will survive compared to 90% of children diagnosed with leukemia in Canada.

The disease burden in developing nations is growing. Caused by an inequity in health, healthcare and resulting disease, the disparities across the cancer care continuum found between rich and poor countries remain largely unaddressed. The cancer divide is the result of these disparities — explained in the report of the Global Task Force on Expanded Access to Cancer Care and Control in Developing Countries-GTF.CCC and in the book Closing the Cancer Divide: An Equity Imperative.

The Cancer Divide

Evidence of this growing burden in LMICs is only beginning to be translated into effective and practical solutions. Traditional rhetoric argues that the challenge of addressing cancer in poor countries is unnecessary, unaffordable, unrealistic, and detracts resources from other more pressing development programs. However, the impending cancer crisis in LMICs remains too large to be ignored. Continue reading “Cancer and the Global Equity Divide: A Call for Action Grace Gawler republished from The Conversation”

TB or not TB? A second opinion on Ian Gawler’s cancer ‘cure’

TB or not TB? A second opinion on Ian Gawler’s cancer ‘cure’

Today Tonight segment; Cancer ‘guru’ miracle worker?

It is hard to believe that one year on from http://www.smh.com.au/national/cancer-experts-challenge-gawlers-cure-20111230-1pfns.html that Channel 7’s Today Tonight (TT) recently chose to run a story that yet again smokescreens the actual question of TB or not TB-in other words; a diagnosis of secondary bone cancer or TB? Writing recently in “The “Conversation”online Prof George Jelinek and Guy Allenby
author of Ian Gawler’s Biography – The Dragon’s Blessing made a creative play on those famous words from Hamlet….To be or not to be with their TB or not TB.

[ ‘The Conversation” is an online independent source of analysis, commentary and news from the university and research sector viewed by 550,000 readers each month.}

I had decided that I was not going to write on this subject on my blog again, however TT and the Conversation both appeared to misrepresent Ian Gawler’s recovery story and promote the implication yet again “If Ian did it I can do it too” theme. This in combination with TT”s cursory glance at a well written hypothesis by eminent professors of Oncology that lasted but a few seconds, left many wondering what the segment was trying to achieve. Anyway the segment concerned me so deeply that to end 2012 – I thought it necessary to make what I hope is a final comment on this subject.

To begin with there are two crucial points to address:

TT gave neither professor a right of reply to address their reasons for the hypothesis they published. Rather we see Prof Ian Olver from the Cancer Council making an unrelated comment about the use of alternative medicine!

In the TT interview Ian Gawler states: “It is clearly a personal attack on his story and his Integrity.”

If patients could access the 2012 IMJ Haines and Lowenthal Hypothesis – They would find in fact that Professors Haines and Lowenthal approached Ian Gawler and his story in a somewhat kindly and dignified manner. Certainly not a Spanish Inquisition or a personal attack as has been claimed! It is on the record in fact that Prof Haines politely asked to review Ian Gawler’s case – and as should have happened in such a public health matter, Ian Gawler accepted then withdrew and the matter was in the hands of a litigator. The Hypothesis paper was then forwarded to the Internal Medicine Journal who appropriately believed it to be in the public interest to publish. Surprisingly, there had never been a medical investigation into the reasons why Ian Gawler recovered.

To quote from Haines and Lowenthal’s controversial IMJ Hypothesis:

“In presenting this hypothesis, we emphasise that we are not in any way criticising the patient’s medical attendants who unquestionably acted fully in accordance with the standards of the time. Indeed, the need to consider obtaining histological confirmation of presumed metastatic disease is only now becoming part of standard oncological practice. We note that one of the leading textbooks of oncology states in its latest edition in relation to possible cancer recurrence: ‘Whenever possible, tissue acquisition for diagnostic confirmation . . . should be considered.’

“Whatever the correct diagnosis, we acknowledge the courage and determination of the patient that allowed him to recover from a prolonged and very debilitating illness. We especially note the psychological resilience that enabled him to overcome the dire prognosis he was given that fortunately turned out to be inaccurate.

Nonetheless, there is an aphorism, attributed to the late Carl Sagan, that exceptional claims require exceptional evidence. We contend that unequivocal evidence that the patient was cured of widespread metastases is lacking, and that the unusual treatments that were employed in this case cannot be held out as an example of a path to be followed by other patients with metastatic cancer.” Continue reading “TB or not TB? A second opinion on Ian Gawler’s cancer ‘cure’”