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重新審視抗癌之戰

重新審視抗癌之戰

Brian Dumaine 2012-02-21
南加州大學著名腫瘤學專家、史蒂夫·喬布斯的主治醫生之一戴維·阿古斯的新作,徹底顛覆了我們已有的大部分醫學知識

????幾年前,在丹佛舉辦的一次全美頂尖腫瘤學家的會議上,知名癌癥專家大衛?阿古斯博士做了一次專題演講,指出有必要采取一種新的方法來治療癌癥。他認為,只關注如何殺死癌細胞或減緩癌細胞的擴散是不夠的。半個世紀以來,盡管世界各地的醫學精英為攻克這一難題進行了不懈的研究工作,但今天的癌癥死亡率并沒有比上世紀50年代降低多少。因此,醫療人員應該想辦法保持病人整個機體的健康,從根本上降低腫瘤在人體內扎根的可能性。他表示,雖然我們目前還不完全了解癌癥的病理機制,不過我們依然應該有辦法控制癌癥。說到這里,聽眾中響起了一陣噓聲。

????不過這點噓聲并不能使像阿古斯這樣堅定的科學家感到氣餒。他相信他已經找到了一種辦法,可以大大降低人體生病的幾率。阿古斯把他的理論寫成了一本有可能具有顛覆意義的新書——《疾病的終結》(The end of illness),這本書剛剛登上了《紐約時報》(New York Times)的暢銷排行榜。阿古斯在書中闡述了他的防病理論,并用相關研究和生動的病例進行了佐證。

????我采訪這位身材瘦削、衣著隨意的醫學家時,他飛快地介紹著他的想法,仿佛唯恐全世界不能盡快了解自己的思想。他說:“我希望醫生們從病人健康時就著手治療,而不是到生病時才去治。”阿古斯的靈感來自他2004年在《財富》雜志(Fortune)上讀到的一篇文章:《為什么我們輸掉了與癌癥的戰爭》(Why We're Losing the War on Cancer)。文章作者克里夫?利夫當時擔任過《財富》雜志編輯,他本人就是一名癌癥幸存者。他寫道,癌癥研究人員們習慣于治療癌癥的各種癥狀,而不是設法直接控制癌癥。史蒂夫?喬布斯去世前的最后幾年,阿古斯也是喬布斯治療團隊的一員。阿古斯說:“我們忘了治癌要從防癌開始。”

????今天,一旦病人得了癌癥,我們就會試圖去殺死癌細胞。如果病人心臟病發作,我們就做心臟搭橋。這無可厚非。但我們為什么不能“防病于未然”呢?阿古斯認為,我們應該把癌癥和心臟病這類疾病看成一個動詞,而不是名詞。在阿古斯的字典里,“患有癌癥”意味著一個系統性的問題。他指出,在一項研究中,一組女性在接受了乳腺癌治療后,醫生向她們發放了一些治療骨質疏松的藥物或安慰劑。但服用了這些藥物的患者的復發率卻比平均水平低了40%。隨著她們的身體系統發生良性改變,癌癥沒有再復發。阿古斯說道:“只要保持土壤健康,壞的種子就無法萌芽。

????保持身體土壤健康的方法之一是治療炎癥。身體出毛病的時候,人體機能就會進入一種恐慌模式,引起炎癥。發炎這個過程就是身體在調動血管、細胞和免疫系統來修復受損的組織。大量研究表明,服用他汀類藥物的病人,患癌幾率會降低40%,只是具體原因尚不明確。他汀類藥物不僅能降低膽固醇,還可以消炎。此外還有越來越多的證據顯示,炎癥可能與大量其它疾病有著聯系,如心臟病、老年癡呆、糖尿病等。阿古斯對此有何建議呢?可以詢問醫生,看看是否可以服用立普妥(Lipitor)或其它的他汀類藥物,或經常服用小劑量阿斯匹林來養生,這有助于人們控制身體的炎癥。

????At a meeting of the nation's top oncologists in Denver a couple of years back, Dr. David Agus, a prominent cancer researcher, was giving a keynote address. Agus talked about the need to take a new approach to treating cancer. He argued that focusing on killing or slowing the spread of cancerous cells was not enough. After all, despite a half-century of research by some of the best medical minds in the world, the death rate from cancer hasn't changed much since the 1950s. Instead, doctors should try to keep a patient's entire system healthy so the disease is less likely to take root in the first place. He said we should be able to control cancer without fully understanding it. At that, hisses arose from the audience.

????A few Bronx cheers aren't enough to discourage a scientist as determined as Agus. He believes he has found a new way to greatly reduce the odds of getting sick and has set out his philosophy in a potentially game-changing new book, The End of Illness, which just became a New York Times bestseller. In it, he offers his prescription for preventive medicine, and backs it with studies and lively anecdotes.

????When I caught up with this slim, casually dressed man, he rattled off ideas as if he couldn't let the world know fast enough about his thinking: "I want doctors to treat toward health and not treat toward disease," he said. Agus had his eureka moment after reading a 2004 Fortune article called "Why We're Losing the War on Cancer," by Cliff Leaf. Himself a cancer survivor, Leaf, a Fortune editor at the time, wrote that researchers have come to treat the individual features of cancer rather than putting their efforts into directly controlling cancer. "We have forgotten that curing cancer," says Agus, who was on the team of doctors who treated Steve Jobs in the last years of his life, "starts with preventing cancer in the first place."

????Today, if we get cancer, we attack the cells. If we get a heart attack, we perform a bypass. That's fine, but why not avoid the disease in the first place? Agus believes that diseases like cancer and heart disease should be thought of as verbs and not nouns. In his lexicon, "cancering" suggests a systemic problem. He points to a study of women who, after treatment for breast cancer, were given either an osteoporosis drug or a placebo. The ones who took the drug had a 40% lower rate of recurrence of the cancer, as their system was changed and the cancer didn't grow back. "Keep the soil healthy," says Agus, "and the bad seed won't grow."

????One way to keep your body's soil healthy is to treat inflammation. When something is wrong with your body, it goes into panic mode and triggers inflammation, a process that rallies the vascular, immune, and cellular systems to heal injured tissue. Numerous studies show that patients who take statins -- which not only lower cholesterol but reduce inflammation -- lowered cancer rates by 40%, although no one knows exactly why. That's not all. A growing body of evidence suggests that inflammation may be linked to a host of other diseases, from heart attacks to Alzheimer's to diabetes. This doctor's orders? Ask your physician if you should be on Lipitor or other statins and a regimen of baby aspirin, which help curb your body's inflammation.

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