Prostate cancer cure - understanding science

Martin Henry, Contributor

I am at that time of life when prostate concerns loom large. Prostate cancer is the leading cause of cancer deaths among Jamaican men. It is a horrible and painful death. And the treatments for late-stage prostate cancer are almost equally horrible.

Jamaica, for unknown reasons, has one of the highest rates of prostate cancer in the world, a disease that is more prevalent among black men than other ethnic groups. So detecting the disease early is crucial. Trying to prevent it is important. And exploring all possibilities for treating the disease is sensible.

For the last ten years or so, I do the detection tests. The basic tests are the blood test for the prostate-specific antigen (PSA), which gets higher with prostate disease, and the digital rectal examination (DRE) which allows the doctor to feel the prostate gland for any enlargement or change in texture by inserting a finger into the rectum. Not too bad - especially when a lady doctor, like my general practitioner, does it - and the alternatives of not catching prostate problems early are considered.

So it is with more than passing interest that I am following the media stories on the discovery of anti-cancer agents in Jamaican plants. Dr Henry Lowe, a prominent Jamaican scientist with his roots in medicinal chemistry, has announced that he and an American research partner, have identified anti-prostate cancer-bioactive agents in the highly placed Jamaican ball moss or Old Man's Beard plant. The plant grows high up on the electric wires which criss-cross the country. Dr Joseph Bryant, a laboratory animal veterinarian in the Institute of Human Virology at the University of Maryland, has worked with Dr Lowe for several years on the project. Some early announcements on the potential of the work were made as far back as 2006 without naming the plant.

The battles continue

Armed with a United States patent, Lowe and colleagues, plus commercial backers, have formed a production company and are going to market offering the ball moss anti-prostate cancer formulation as a nutraceutical, rather than a fully developed pharmaceutical which would require years of further development work and cost millions of US dollars. There are hundreds, if not thousands, of such nutraceutical and herbal products on the market and Lowe and company want to capture a slice of this lucrative global market, for themselves and for Jamaica.

Immediately, a clash has emerged between conventional medicine and the new product, with the public caught in the middle. This could be regarded as another round in the old battles between allopathic, or so-called scientific medicine, and naturopathic medicine, except that the Henry Lowe team has done rigorous conventional scientific work which has earned the respect and seal of approval of some elements of the scientific and drug-development communities.

The debate is healthy, and I want to commend the media for carrying it with such prominence and tenacity. We must not follow the advice of Dr Lowe's friend, colleague and co-author of one of his many books, medical doctor and professor Winston Davidson. Professor Davidson, now head of the School of Public Health and Health Technology at the University of Technology speaking at the Observer Monday Exchange last week, appealed to the scientific community to discuss issues among themselves before going public. This is going counter to a worldwide movement for the public understanding (and public engagement) of science (PUS). PUS becomes PUSET when engineering and technology are added to the acronym. The men and women in white coats, with all the wonders they have wrought for the benefit of mankind, have also generated considerable harm which, cumulatively, imperils an entire planet. PUS is now an academic discipline in its own right, with its own journals and university departments. The public has a right to know, and to participate in the discussions on science and technology in society. It is the public which pays for the research, uses the results of the research, and absorbs the consequences, bad and good, of the research.

Government, with tax dollars, funds a great deal of the scientific research, but even when personal resources are used as in Dr Lowe's case, the public still 'pays'. It is the business of scientists to make their work understandable to the public in reasonable fashion. And media play a very important role in mediating the communication between scientists and public.

We have trying for a long time to cultivate 'Science Journalism' in Jamaica to try and catch up the developed world where it is an established beat. A few years back I taught several cycles of an elective, 'Science, Society and Media', at The Caribbean Institute of Media and Communication (CARIMAC), University of the West Indies (UWI), which graduated about 60 or so takers.

Alma Mock Yen, when she headed UWI's Radio Education Unit, and I, did our bit for the popularisation of science through the long-running radio programme 'Science Serving Us'. It is not only the canned stuff of science textbooks on which the scientific community agrees that the public needs to know. The public needs to be aware of the controversies within science which will ultimately affect them in practice. And hardly anywhere is this most necessary and urgent than in health care.

It was most heartening to see an executive editor, Vernon Davidson of the Daily Observer bylining one of the many stories carried in print on the ball moss anti-cancer drug issue, and the paper editorialising on the matter. Both newspapers have devoted considerable space to the proponents and opponents of the alpha prostate formula due to go to market in three months. Editors should put more staff and time on science reporting.

Once you get past the techno-jargon of in vitro and in vivo, and 'a compound soyasasponin 1 which has been shown to be a sialotransferase inhibitor, and apoptosis', the last two phrases appearing in Dr Joseph Bryant's letter to the press, there are some basic things the public needs to know about a new medicine. Alpha prostate formula is not quite a pharmaceutical drug yet in the conventional sense. It is a crude plant extract claiming bioactivity against prostate cancer.

We need to know the efficacy and the safety of the product. That is, does it work and how well does it work, and what degree of risk might be attached to using it? It is well to bear in mind that all drugs and medical interventions have side effects and what we want to achieve is more positive effects than negative ones. And costs cannot be ignored. Drug development costs millions of dollars and the pharmaceutical companies want to make a killing off their investments, often quite literally a killing as in the case of AIDS drugs, which the most affected but neediest people can't afford either personally or at State level. Nutraceuticals and herbal medicines are generally more affordable alternatives, which if they have some demonstrable efficacy, cannot be lightly dismissed.

The Jamaica Urological Society, 'the local association of urologists who are surgical specialists concerned with the treatment of genito-urinary disorders, such as prostate cancer', and in particular Dr William Aiken, a leading urologist, have raised these questions. But, again, we must bear in mind that these practitioners are committed to the conventions of the status quo and are almost reflexively critical of alternatives. But that scepticism can be healthy.

The public has no capacity for independent verification and so must rely on the State authorities to conduct a rigorous approval process. The matter is further complicated by the shielding of research data for commercial reasons, which is a serious issue in scientific research and publication today. The call by the urologists for the publication of complete scientific data on which a commercial product is based is not altogether reasonable.

Where is the umpire? A nutraceutical is allowed to make only limited and carefully circumscribed claims about its (likely) efficacy. We expect the public authorities to do the reviews and the regulating, providing clear information in ABC language.

People the world over, Jamaicans no less, are mixing traditional and modern medical approaches, the naturopathic and the allopathic, the nutraceutical and the pharmaceutical. Information helps in making wise choices. There is, for instance, a growing body of information which is sharply critical of the conventional treatments for prostate cancer, pointing out an aggressive over-reliance on invasive surgery and chemotherapy which can have devastating side effects.

• JOHN MAXWELL

John Maxwell has died of lung cancer, leaving a rich legacy in journalism and some important life lessons. One such lesson from the environmentalist who smoked from age 15 is: Don't smoke. That way you will lower, by hundreds of times, your risk of developing lung cancer. There are available some valuable lifestyle practices for reducing the risks of prostate cancer. Cutting red meat, and raising soya consumption and the consumption of foods, like tomato, rich in lycopene are pretty well established as prostate cancer risk reduction approaches.

I used John's well-written little book, How To Make Our Own News: A Primer for Environmentalists and Journalists, in teaching that CARIMAC course I mentioned earlier, "Science, Society and Media".

John and I, who didn't see eye to eye on so many things, didn't only quarrel from time to time in the press, but collaborated in a May 2002 workshop for building a science-communication network for the Caribbean. The Scientific Research Council and the India-based Committee on Science and Technology for Development hosted the workshop and invited me to help as a 'science journalist', being one of the few people writing about science in the country at the time. I quietly recommended Maxwell as the best mainstream journalist, for presenting techniques to the workshop, largely on the strength of his 2000 book, How To Make Our Own News.

Martin Henry is a communications consultant. Feedback may be sent to columns@gleanerjm.com