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重新审视抗癌之战

重新审视抗癌之战

Brian Dumaine 2012-02-21
南加州大学著名肿瘤学专家、史蒂夫·乔布斯的主治医生之一戴维·阿古斯的新作,彻底颠覆了我们已有的大部分医学知识

    几年前,在丹佛举办的一次全美顶尖肿瘤学家的会议上,知名癌症专家大卫•阿古斯博士做了一次专题演讲,指出有必要采取一种新的方法来治疗癌症。他认为,只关注如何杀死癌细胞或减缓癌细胞的扩散是不够的。半个世纪以来,尽管世界各地的医学精英为攻克这一难题进行了不懈的研究工作,但今天的癌症死亡率并没有比上世纪50年代降低多少。因此,医疗人员应该想办法保持病人整个机体的健康,从根本上降低肿瘤在人体内扎根的可能性。他表示,虽然我们目前还不完全了解癌症的病理机制,不过我们依然应该有办法控制癌症。说到这里,听众中响起了一阵嘘声。

    不过这点嘘声并不能使像阿古斯这样坚定的科学家感到气馁。他相信他已经找到了一种办法,可以大大降低人体生病的几率。阿古斯把他的理论写成了一本有可能具有颠覆意义的新书——《疾病的终结》(The end of illness),这本书刚刚登上了《纽约时报》(New York Times)的畅销排行榜。阿古斯在书中阐述了他的防病理论,并用相关研究和生动的病例进行了佐证。

    我采访这位身材瘦削、衣着随意的医学家时,他飞快地介绍着他的想法,仿佛唯恐全世界不能尽快了解自己的思想。他说:“我希望医生们从病人健康时就着手治疗,而不是到生病时才去治。”阿古斯的灵感来自他2004年在《财富》杂志(Fortune)上读到的一篇文章:《为什么我们输掉了与癌症的战争》(Why We're Losing the War on Cancer)。文章作者克里夫•利夫当时担任过《财富》杂志编辑,他本人就是一名癌症幸存者。他写道,癌症研究人员们习惯于治疗癌症的各种症状,而不是设法直接控制癌症。史蒂夫•乔布斯去世前的最后几年,阿古斯也是乔布斯治疗团队的一员。阿古斯说:“我们忘了治癌要从防癌开始。”

    今天,一旦病人得了癌症,我们就会试图去杀死癌细胞。如果病人心脏病发作,我们就做心脏搭桥。这无可厚非。但我们为什么不能“防病于未然”呢?阿古斯认为,我们应该把癌症和心脏病这类疾病看成一个动词,而不是名词。在阿古斯的字典里,“患有癌症”意味着一个系统性的问题。他指出,在一项研究中,一组女性在接受了乳腺癌治疗后,医生向她们发放了一些治疗骨质疏松的药物或安慰剂。但服用了这些药物的患者的复发率却比平均水平低了40%。随着她们的身体系统发生良性改变,癌症没有再复发。阿古斯说道:“只要保持土壤健康,坏的种子就无法萌芽。

    保持身体土壤健康的方法之一是治疗炎症。身体出毛病的时候,人体机能就会进入一种恐慌模式,引起炎症。发炎这个过程就是身体在调动血管、细胞和免疫系统来修复受损的组织。大量研究表明,服用他汀类药物的病人,患癌几率会降低40%,只是具体原因尚不明确。他汀类药物不仅能降低胆固醇,还可以消炎。此外还有越来越多的证据显示,炎症可能与大量其它疾病有着联系,如心脏病、老年痴呆、糖尿病等。阿古斯对此有何建议呢?可以询问医生,看看是否可以服用立普妥(Lipitor)或其它的他汀类药物,或经常服用小剂量阿斯匹林来养生,这有助于人们控制身体的炎症。

    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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