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December 2003

The Crumbling Walls of Medical Ignorance

To encourage more physician vigilance, Dr. Lenfant cites a study showing that very careful monitoring and appropriate adjustment of the treatment regimen resulted in an increase in the rate of blood-pressure control from 27% to 66% in a study group of more than 42,000 patients.30 While doctors may be impressed by this study, it confirms Life Extension’s long-standing position that conventional medicine is largely failing hypertensive patients. Life Extension has previously advocated the need for multi-modality approaches if blood pressure is to be brought down to optimal levels.

Medical Miranda Right for the Patient
You have the right to be informed in a timely fashion of the latest medical advances and to be given the proper instructions for implementing therapies that have the potential to favorably alter the course of your life.

You have the right to be informed of which research developments of proven value––based on the peer-reviewed literature––your insurance company is withholding from you due to economic reasons. Such a denial of proven therapies, in the context of human life, equates with a conflict of interests and a flagrant denial of human rights.

Medical Miranda Right for the Physician

You have the right to assume that your recommendations to patients, whose lives have been entrusted to you, will be faithfully followed. The failure to do so violates the contract between physician and patient, and equates with a loss of time, talent, and treasury for all parties.

You have the right to expect accountability and responsibility on the part of patients to resolve all medical issues brought to their attention, and to be actively involved in the healing process.

What About Complicated Therapies?
Dr. Lenfant’s greatest concern is whether today’s physicians will translate the findings of complex scientific innovations into improved medical therapies. Dr. Lenfant points to the marvelous discoveries being made today and notes that we are “on the threshold of a new era in which gene-centered medicine will almost certainly be the star player.”31 The June 2003 issue of Life Extension magazine described a breakthrough in genetic research (funded by the Life Extension Foundation) that could rapidly lead to the development of therapies to slow and reverse aging.

In concluding his New England Journal of Medicine article, Dr. Lenfant emphasizes the need for research whose results are likely to be applied to the clinical setting and not remain confined to scientific journals:

“Enormous amounts of new knowledge are barreling down the information highway, but they are not arriving at the doorsteps of our patients…This issue of who will really benefit from research results is especially critical as we look toward applications of genomic research…Let’s be realistic: If we didn’t do it with aspirin, how can we expect to do it with DNA?”

Dr. Lenfant’s apprehension that apathetic doctors will fail to implement lifesaving research discoveries is an issue that has long been raised in the pages of this magazine. What Dr. Lenfant did in his seven-page article was identify specific published studies proving that doctors have not applied research findings to save patient lives. This New England Journal of Medicine article was published on August 28, 2003.

An article published in the July 2003 edition of Life Extension magazine titled “Bridging the Gap Between Science and Medicine” described many of these same overlooked medical discoveries.32 Dr. Lenfant’s New England Journal of Medicine article corroborates Life Extension Foundation’s long-standing position that Americans have been subjected to senseless morbidity and needless deaths.

Too Much Knowledge, Not Enough Practical Application
When research discoveries are not delivered to patients, the inevitable result is less than optimal care. For those who suffer from a non-life-threatening condition, this absence of applied knowledge means their agony may not abate. For people suffering lethal medical conditions, the result of their physicians not taking advantage of current treatment findings often is premature death.

The rapid advances in the biomedical sciences are both frightening and encouraging. The alarming fact is that people are dying because their doctors are not keeping up with the latest treatment breakthroughs. The reassuring aspect is that patients can educate themselves to better work with their physicians to mitigate or cure lethal diseases. When a patient and physician work together as an enlightened team, lifesaving miracles can occur as opposed to needless suffering and fatality.

What surprised us about Dr. Lenfant’s New England Journal of Medicine article is that it uses similar verbiage and contains criticisms of the medical establishment long espoused by the Life Extension Foundation. We were especially gratified to see that Dr. Lenfant independently came to the same conclusions we did about the failure of doctors to use documented scientific findings to improve patient care.

Wall Street Journal Recognizes Problem
The September 26, 2003 issue of the Wall Street Journal featured an article titled “Too Many Patients Never Reap the Benefits of Great Research.”

According to the article, today’s doctors “often fail to pass on to the patients the fruits of any discoveries.“

The former president of the American Heart Association, Dr. Sidney Smith, stated: “To spend $26 billion (NIH’s 2004 budget) in basic research and not get the benefits to the patients is crazy. It’s a huge waste and a tragedy.”

The Wall Street Journal article described doctors failing to provide comprehensive treatment to diabetics, not giving anti-platelet therapy to stroke victims, and neglecting to urge those with lower back pain to get out of bed. A team of researchers from the Rand Institute concluded that these lapses “pose serious threats” to the health of the public.

Today’s doctors were chastised for not practicing evidence-based medicine. One infamous case was cited from the 1990s, when a federal research group published a study showing that spinal fusion surgery usually does no good. Orthopedic doctors did the equivalent of grabbing pitchforks and storming the castle. They lobbied Congress to punish the research group (Agency for Healthcare Research and Quality) and crippled for years the very idea of science-based medicine.

Sidney Smith, M.D., currently professor of medicine at the University of North Carolina stated that “a large part of the problem is the real resistance from physicians…many of these independent-minded souls don’t like being told that science knows best.”

Translational Medicine
Since 1980, the Life Extension Foundation has provided its members with information that is routinely disregarded by the medical establishment. Our mission has been to translate diverse scientific findings into therapeutic protocols that can be understood by our members and their physicians. This concept is increasingly being referred to as “translational medicine.”

Physicians learn about new discoveries at scientific conferences, from medical journals, and on the Internet. However, only a tiny fraction of these doctors translates this knowledge into enhanced treatments for their patients. In fact, physicians treating seriously ill patients often fail to use many established medical advances.

For instance, the scientific literature documents that, if a cancer or congestive heart disease patient is anemic, his or her chance of survival is greatly reduced. In their everyday practice, however, few physicians are aggressive in their evaluation and treatment of anemia, even though anemia correlates directly with increased mortality.

A conflict of interests has arisen in the context of modern-day medicine that prohibits translational medicine, as described herein, in the name of cost-effectiveness for the HMO. However, what managed care in its immediate greed has failed to see is that using measures to prevent illness and diagnosis disease earlier will translate into savings of lives and of health care dollars. It even keeps their clients alive longer so that they can keep on paying insurance premiums. In these times of increasing numbers of patients constrained by managed care, major advances in health care could be realized if someone were

to show the accountants and CEOs of HMOs how pro-active translational approaches save lives and money at the same time. Life Extension has long emphasized the need for physicians to practice translational medicine for the benefit of their patients. The director of the National Heart, Lung and Blood Institute, Claude Lenfant, M.D., has reached the same conclusions.

Cancer patients are often shocked to learn that most conventional oncologists are not utilizing novel information contained in their own journals. The failure of oncologists to practice translational medicine helps explain why more Americans are dying of cancer than ever before, despite major advances made in the research laboratory.

A review of past medical discoveries reveals how excruciatingly slow the medical establishment is to adopt novel concepts. Even simple methods to improve medical quality often meet with fierce resistance.

Over the past three decades, Life Extension has been privileged to interact with scientific pioneers who have developed novel solutions for preventing and treating degenerative disease. Medical history documents that bureaucratic committees do not make discoveries. Instead, it is the individual with an insatiable desire for knowledge who innovates by thinking beyond prevailing dogmatic principle.

The Life Extension Foundation is a network of individuals who are passionate about ending today’s epidemic of unnecessary disease and death.