Merck’s continued looting of state and federal public health budgets for a dangerous and unnecessary vaccine is unsustainable and has to stop.

There are better, safer, more sustainable ways to prevent and treat cervical cancer both at home and in developing countries.  Safety, and ethical issues aside, as a country, we simply cannot afford the Merck solution. There are too many other critical demands for public and private health dollars.

In early 2006, when I first started writing about Gardasil, I questioned the necessity of a very expensive, possibility unsafe vaccine for a disease that was easily detected through the use of regular PAP screens and was the most treatable and curable of all cancers. According to the American Cancer Society, fewer than 4,000 lives are lost annually to cervical cancer in America. These women, precious mothers, sisters, daughters, all, could have been saved with affordable access to PAP tests. The logical answer to me was finding a way to get low income and new immigrant populations into neighborhood clinics… problem solved, women and girls did not need Gardasil.

The “500,000-Cervical Cancer Deaths” Merck touted in their marketing blitzkrieg as their HPV vaccine’s justification, referred to women in developing countries who died due to inadequate access to existing medical solutions.

Convinced that Merck’s HPV vaccine, the $400 per series  Gardasil, was simply not appropriate technology for the existing threat, I also reported on the Alliance for Cervical Cancer Prevention (ACCP) work with ‘Visual Inspection with Acetic Acid (VIA) as a low cost, easily deployable, alternative to the PAP Smear.

For middle-aged women in the developing world, cervical cancer is one of the leading causes of death. Cervical cancer is almost completely preventable, if precancerous lesions are identified and treated in a timely manner. Cervical cancer screening based on cytological examination is largely unavailable in developing countries or, made available to a small, select group of women in private facilities, maternal child health sites, or family-planning clinics, missing the age groups at highest risk for precancerous lesions.

Visual inspection with acetic acid (VIA) can be used to screen women. It can be done by nurses or midwives with appropriate training. Research results show that VIA is simple, accurate, cost-effective, and acceptable to most women. Visual inspection with acetic acid (VIA) can be done with the naked eye (also called cervicoscopy or direct visual inspection [DVI]), or with low magnification (also called gynoscopy, aided VI, or VIAM).  VILI, another variation of the visual inspection, known as Schiller’s test, uses Lugol’s iodine.

Various world health organizations and charities have been actively deploying VIA solutions in Latin America, Africa and India since the late 1990’s. By 2002 and 2003 promising results had been reported. For a very, low cost, (under $20) cervical cancer was being detected and treated successfully. When the BIG FOOT of Merck can crashing down, it lobbied for funds previously committed to more sustainable technologies.

Could the millions Merck wheedled from the Bill and Melissa Gates Foundation for doses of over-priced, possibly unsafe, vaccines be more effectively allocated? In my opinion — Yes!

As healthcare dollars become scarcer, all of us are going to ask, “What is sustainable? What solution will help the greatest number of people, affordably? What is the least invasive solution, with least opportunity for harmful side effects?”

When public health officials and medical practitioners start asking those hard questions, Merck’s HPV vaccine, Gardasil will not be the objective answer.

ACCP partner organizations in ongoing VIA research are: EngenderHealth ; International Agency for Research on Cancer (IARC);  JHPIEGO; Pan American Health Organization (PAHO);   Program for Appropriate Technology in Health (PATH)

Sources: Evaluation of visual inspection with acetic acid (VIA), Lugol’s iodine (VILI), cervical cytology and HPV testing as cervical screening tools in Latin America : this report refers to partial results from the LAMS (Latin American Screening) study
http://repositorium.sdum.uminho.pt/handle/1822/4033

Test characteristics of visual inspection with 4% acetic acid (VIA) and Lugol’s iodine (VILI) in cervical cancer screening in Kerala, India.
Sankaranarayanan R, Wesley R, Thara S, Dhakad N, Chandralekha B, Sebastian P, Chithrathara K, Parkin DM, Nair MK.

International Agency for Research on Cancer, 150 cours Albert Thomas, Lyon 69008, France. sankar@iarc.fr
http://www.ncbi.nlm.nih.gov/pubmed/12845681

Cervical cancer screening in low resource settings using visual inspection with acetic acid. Carr KC, Sellors JW. Seattle University, College of Nursing, Seattle, WA 98122, USA. Kcarr@seattleu.edu
PMID: 15236713 [PubMed – indexed for MEDLINE

©2012 An Inconvenient Woman. All Rights Reserved.

Researchers Find Mental Tasks Cause People to Eat More

As a so-called knowledge worker, who spends more time on my computer then on my mattress, I found the following article by Lee Dye, published on ABC News, Online, September 10, 2008, fascinating and frightening. The majority of women hold “Think-Work” positions. If focus and concentration stimulates our appetites as indicated in the sited study, we are going to have to find a new strategy for “desk-bound” wellness.

Angelo Tremblay noticed something odd every time he worked up a grant application for his research program in a Quebec university. He had a craving for chocolate chip cookies.

Now, thanks to research in his lab at the Universite Laval, he has a better understanding of why. It turns out that performing mental tasks, like trying to solve problems while working at a computer, stimulates the appetite so much that people tend to eat significantly more calories than they burned while performing the “knowledge-based” tasks.

In a study published in the current issue of Psychosomatic Medicine, researchers found a physiological basis for the spike in appetite. Mental work “destabilizes” the levels of insulin and glucose, two critical components in the body’s regulatory and energy machinery, thus stimulating the appetite, said Jean-Philippe Chaput, lead author of the study.

“The brain uses only glucose for energy,” unlike the “muscles, which use fat and glucose,” Chaput said in a telephone interview. So when the level of glucose, or sugar, becomes unstable, the brain demands more.

According to the research, participants consumed far more calories after performing mental tasks than they consumed after relaxing for the same period of time.

The study is quite small, involving only 14 women, so the results are only tentative, but Chaput said he and his fellow researchers have already embarked on a larger study involving 50 men and 50 women. Only women were used in the pilot study because it has been well established that men and women react differently to stress, and the researchers did not want to cloud the results.

At this point, however, the study indicates that a rapidly changing lifestyle toward “knowledge-based work,” like time spent at the computer or trying to solve mental challenges, may be a significant factor in the current obesity epidemic, Chaput said.

“There are a lot of people doing this kind of work now, compared to physical work in the past, so we postulate that it can explain in part” why so many people in so many countries are getting fat, he said.

As the researchers put it in their paper, “knowledge-based work represents the main working modality in a context of modernity.” In other words, many are spending fewer calories, but taking more in, because of changes in the work environment.

That’s true not only in the world of employment, but in the world of entertainment as well. Many people are spending more time playing computer games, some of which can be intellectually challenging, than playing tennis, for example.

The researchers are members of the university’s department of medicine, and they specialize in kinesiology, the mechanics and anatomy of human movement. The 14 women in the study were all students, ranging in age from 20 to 30 years. All were in good health, with no eating disorders, normal weight, and free of food allergies.

During a two-month period they were each required to participate in three 45-minute exercises consisting of relaxing in a chair, reading a document and writing a summary of 350 words, and “a cognitive task consisting of a comprehensive battery of computerized tests.”

Each participant was tested separately from the others.

Each “came into the lab at 8 a.m., and we gave each participant a standardized breakfast,” Chaput said. “After that we started the exercise at 10:30 a.m., one participant at a time, and they came every two weeks. At about 11:30 a.m. we gave them a buffet type of meal, comprising a lot of food.”

The food in the buffet was weighed and analyzed before and after the lunch, so researchers knew precisely how much and which type of food each participant had eaten. Various tests during each exercise also told the researchers precisely how many calories the participants were burning at the time.

The participants burned only about three calories more during each of the two “knowledge-based” experiments than during the 45 minutes when they rested in a comfortable chair. So the caloric expenditures were relatively quite low for mental tasks compared to the period spent relaxing.

But the intake was significantly higher. Participants consumed 203 more calories after the reading experiment, and 253 more calories after the computer tests, than the resting participants. That’s an increase of 23.6 percent and 29.4 percent, respectively.

Measurements of glucose and insulin became quite erratic during the mental tests. Glucose soared almost immediately when the participants were reading and then dropped dramatically. It dropped and remained below normal during the computerized tests. Insulin rose slightly during the reading test, and then dropped, and it dropped steadily during the computer tests.

That erratic performance by both glucose and insulin caused the appetite to rise, apparently in response to a need to restore the energy balance, the researchers conclude. The results probably would have been different if men had been included in the study, as they will be in future research. That’s because mental challenges provoke stress, and it “is expected to be higher in females than in males,” according to Chaput. That is also reflected in many other studies. He said women also tend to eat more following stress than men do, although “we don’t know why yet.”

Although the first study was limited to college-aged participants, Chaput said other research in his lab suggests that the same findings will apply to children as well as to older adults.

But if mental challenges cause people to eat more food, why aren’t nearly all college professors fat?

Simple, Chaput said. Eating is only part of the weight control “package,” he added. It’s possible to spend a lot of time working out problems at the computer if that is balanced with a reasonable amount of time working out, literally.

Some college professors, of course, are fat. Maybe the skinny ones use their computers on the treadmill.

Lee Dye is a former science writer for the Los Angeles Times. He now lives in Juneau, Alaska.

©2012 An Inconvenient Woman. All Rights Reserved.

Please take the time to visit the Sister Study web site.

The Sister Study is the only long-term study of women aged 35-74 whose sister had breast cancer.  It is a national study to learn how environment and genes affect the chances of getting breast cancer.  A total of 50,000 women will join the effort to find the causes of breast cancer

WHO CAN JOIN THE SISTER STUDY?

You may be eligible to join the Sister Study if —

• Your sister, related to you by blood, had breast cancer.
• You are between the ages of 35 and 74.
• You have never had breast cancer yourself.
• You are a woman living in the U.S. or Puerto Rico.

SISTERS ARE STILL NEEDED!

As we approach our goal of enrolling 50,000 diverse sisters, we want to make sure that groups not yet as well represented among participants have an opportunity to join. Unfortunately, this means turning away some women who are already very well represented in the study group. Caucasian women ages 35-64 with more than a high school degree will no longer be able to enroll, but can help the Sister Study in other ways.  This group is now very well represented among our current participants

We still need women from the following groups to enroll in the Sister Study:

• African Americans, Latinas, Asians and Pacific Islanders, and Native Americans between ages 35-74
• Caucasian women between the ages of 65-74 or with a high school degree or les

CAN YOU JOIN NOW?

If you need help determining whether you can join at this time, please call our toll free number 1-877-4SISTER or CLICK HERE to answer the screening questions at the Sister Study web site.

You can be a part of this landmark research effort to find the causes of breast cancer.

Join the Sister Study for your daughters, nieces,

granddaughters, and future generations!

Visit the Sister Study Homepage

©2012 An Inconvenient Woman. All Rights Reserved.