The Cure for Cancer
Author: Jian Gao, PhD
Editor: Mr. Frederick Malphurs
July 4, 2023
No amount of money can end the cancer problem if more people keep developing the disease
— Clifton Leaf, former editor-in-chief of Fortune magazine
1. Take off the Rose-colored Glasses to see the Past, Present, and Future
More than 50 years have passed since President Richard Nixon declared war on cancer in 1971 by signing the National Cancer Act. And 20 years have passed since 2003 when Andrew von Eschenbach, former president-elect of American Cancer Society, Director of National Cancer Institute (NCI; 2002-2006), Commissioner of the FDA (2006–2009), pledged “to eliminate suffering and death due to cancer by 2015.” During the last 50 years NCI’s budget has increased by 15-fold to $7.3 billion in 2023 and will likely swell more thanks to the renewed Cancer Moonshot. In addition, nearly 3,000 IRS recognized cancer-focused charities have raised hundreds of billions of dollars for cancer research and treatments. Yet, cancer remains largely an untamed beast inflicting immeasurable sufferings on humankind.
How many of us do not have loved ones or close friends inflicted with cancer? According to the American Cancer Society, an organization constantly trumpeting victories over cancer, 40% of men and 38% of women will get cancer in their lifetime.1 Researchers from Queen Mary University of London concluded, 1 out of 2 in the UK will get cancer in their lifetime (54% of men and 48% of women).2 Worldwide, “The number of new cases is expected to rise by about 70% over the next 2 decades,” according to the World Health Organization.3 And a picture is worth a thousand words:
2. Win the Battle but Lose the War
How did we get here? For one, we have a medical system driven by profit or revenue rather than public health – a world without cancer and other chronic diseases is not great news for the bottom line of the cancer industry and medical establishment. And although our doctors want to cure their patients with debilitating diseases, the medical system is set up such that they are mostly paid by how many patients they see or how many procedures they perform, not by the long-term health outcomes of their patients.
The misdirected incentive riding on the sky-high desire for finding cures created a monster cancer industry costing hundreds of billions of dollars each year. Of course, money-chasing alone would not have gotten us into this quandary – early success in treating cancer has played a pivotal role. To understand the intricacies, we need to look at the CML (chronic myelogenous leukemia) and Gleevec (Imatinib) story.
CML, a type of cancer of the bone marrow making too many white blood cells, was a slow but almost always fatal disease before Gleevec, a cancer drug, was developed just little over 20 years ago.
In 1969, when examining cancer cells from patients with CML, Dr. Peter Nowell, a pathologist at the University of Pennsylvania, and his associate David Hungerford observed something odd – one of the 46 chromosomes was abnormally short. Further research revealed 95% of patients with CML have the short chromosome, which was later named “the Philadelphia chromosome.” As the techniques for studying DNA improved in the 1970s, researchers revealed the Philadelphia chromosome (also known as BCR-ABL) forms when two chromosomes (#22 and #9) break and the pieces swap places; as a result, chromosome 22 is shortened and becomes the BCR-ABL which encodes tyrosine kinases (a group of enzymes playing crucial roles in cell functions) driving uncontrolled cell divisions of cancer.
In the 1990s, researchers started to identify a chemical compound which can block the function of tyrosine kinases. Thus, Gleevec was born – a wonder drug putting patients with CLM in remission by precisely blocking the functions of the tyrosine kinases which causes cancer. Gleevec, a truly landmark drug hailed as the beginning of the end of cancer, since 2001 when it was approved by the FDA, has cut mortality rate by nearly two thirds. Today, for those with CML who are in remission after two years of imatinib (Gleevec) treatment have the same life expectancy as others who do not have the cancer,6 which is nothing short of a miracle.
Gleevec was the first smart bomb in the war against cancer – it specifically targets the enemies with little collateral damage, unlike the traditional chemotherapies killing both friends and foes. The discovery of Gleevec mesmerized cancer drug developers, grant funding as well as regulatory agencies, the media, and even the general public – Gleevec set a shining paradigm for cancer research and treatment – targeted therapies.
Unfortunately, the success of Gleevec has sent cancer research on a wild-goose chase for the last 20 years: “The Gleevec Story is deadly in its seduction: siren like, it has taken the global cancer-fighting enterprise down a perilous pass – a path that can never lead us to victory in the war on cancer,” wrote Clifton Leaf, former editor-in-chief of Fortune magazine.
The paradigm of targeted therapies has vastly underestimated the complexity of other cancers. In most CML patients, especially at the early stage, the gene mutations in the cancer cells are rather homogeneous – mostly BCR-ABL. As a result, the cancer cells are like sitting ducks with a unique target on their back waiting to be hit. And CML is a relatively rare disease – fewer than 9,000 new cases each year in the US, less than 0.5% of all new cancer cases.
On the other hand, in almost all other cancers and even later stages of CML, the malignant cells are always on the move, and doing so very rapidly (e.g., glioblastoma can grow 1.4% in a single day – doubles every 50 days). The mind-boggling variation of mutations are not only drastically different from person to person but also from cell to cell within the same patient and change quickly with time. As elucidated by Clifton Leaf in his scholarly well-researched book The Truth in Small Doses, the dynamic complexity and adaptability of these ‘clever’ malignant cells have rendered most treatments including targeted therapies and immunotherapies ineffective and have stalled the war on cancer.
Sadly, the cancer establishment has refused to walk out of their preferred dreamland to face the brutal reality of the cancer war. “For four decades, I have been hearing the same glowing predictions about the magic treatment just around the corner, resulting from a better understanding of oncogenes, tumor suppressor genes, the human genome and transcriptome, the immune system, or choking off blood supply to tumors. Most have fallen flat when brought to the bedside,” wrote Azra Raza, MD, a leading cancer research expert, passionate oncologist caring for patients, Professor of Medicine and Director of Myelodysplastic Syndrome Center at Columbia University, in her science-based and heart-felt book The First Cell. “No one is winning the war on cancer.”7
Of course, the cancer industry loves to remind us about other successes. Yes, we know that. For example, the five-year survival rate of childhood acute lymphocytic leukemia (ALL – a relatively rare cancer in the US: 3.7-4.9 cases per 100,000 children of 0-14 years) was about 14 percent in the early 1960s; now it is up to 90 percent. That is truly great progress, but we also should not turn a blind eye to the brutality of the treatment – 2 to 3 years grueling chemotherapy, coming with not only a myriad of ‘short-term’ side effects (nausea, vomiting, mouth sores, loss of appetite, diarrhea, constipation, fatigue, fever, pain, and hair loss etc.) but also long-term risk of heart problems, stroke, lung tissue damage, nerve damage (peripheral neuropathy), kidney problems, infertility, and the worst of all – a second cancer.
All in all, the war on cancer has stalled, to say the least. That is the cold reality. If meaningful progress has been made, why did the rich, famous, and powerful have to die: Steve Jobs, Paul Allen (Microsoft Co-Founder), Senator Ted Kennedy, Beau Biden, and Senator John McCain, just to name a few, not to mention all the average folks killed by this horrible disease. With a few exceptions, if the malignance cannot be completely surgically removed, the prognosis is dim.
Despite more than 50 years of effort with hundreds of billions of dollars poured into cancer research, overall, it seems, paradoxically, we know less and less about the nature of cancer – nobody can even be sure whether cancer is a genetic disease, metabolic disease or an immune disease. It is true every cancer cell has genetic mutations, but they are acquired later in life rather than from their parents. So, what causes these mutations? If cancer is a metabolic disease, what drives the metabolic process awry? And if it is an immune problem, what triggers the immune system to malfunction?
The cancer establishment, comprised of interest groups as well as individuals,8,9 sadly including charity organizations and even government agencies,9,10 has refused to look at root causes – single mindedly fixated on finding ‘cures’ relying on slash-poison-burn (surgery, chemotherapy, radiology), blocking and suppressing (targeted therapy) and massive killing (immunotherapy).
Without understanding and dressing the root causes, how can cancer be cured? Even for those cancers that can be surgically removed, who knows when they will come back?
3. What Causes Cancer?
Genes
For cancer, and any other chronic or ‘incurable’ diseases for that matter, genes have become the #1 scapegoat. Cancer and other chronic diseases like metabolic disorders and autoimmune diseases have soared during the last 80 years. Age-adjusted cancer mortality rate (number of deaths per 100,000 population) in particular jumped 75 percent for males during 1930s-1990s,11 with the incidence rate increasing much faster. Have the genes of a population changed in the same period? Even if they are changed, the changes would reduce the number of people getting the disease – natural selection as a result of evolution.
If genes were the main driver of cancer, twins sharing the same DNA should have a high concordance rate of getting cancer. But that is not the case at all. After analyzing 44,788 pairs of twins listed in the Swedish, Danish, and Finnish twin registries, a study published in the New England Journal of Medicine found the rates of cancer concordance in twins were generally below 0.10 and concluded “that the overwhelming contributor to the causation of cancer in the populations of twins that we studied was the environment.”13
There is no doubt the changing environment is the culprit. Even for those carrying BRAC1 or BRAC2 mutations, the risk of getting breast cancer was 24 percent before 1940, but now it is nearly 80 percent.12
Another popular thesis is the “bad-luck” theory – cancer is mainly caused by random genetic mutations and therefore unpreventable. The theory was created by two articles published by two Johns Hopkins researchers in the journal Science, one of the most prestigious science journals.14 The thesis is based on the “observation that, in the United States, the lifetime risk of cancer among 25 different tissues were strongly correlated with the total number of divisions of the normal stem cells in those tissues.”15 Because the number of random errors or mutations in each division is largely constant (about three mutations per stem cell division), the authors inferred that cancer was caused by random errors in DNA replication. Based on statistical correlations, the authors concluded two third of cancers were due to these random errors that are intrinsic and unpreventable.
Despite being thoroughly refuted by other studies,16-29 the “bad-luck” theory has been propagated to the public by academic journals, mainstream and social media with sensational titles like “The Randomness Of Life: Bad Luck Cancers,” “Cancer’s Random Assault,” and “Bad Luck of Random Mutations Plays Predominant Role in Cancer, Study Shows.”
Just leave the studies and attention-grabbing headlines aside for a second, commonsense tells us the premise of this bad-luck theory is beyond laughable – of course, cancer is more likely to grow in tissues where cells divide rapidly – cancer does not grow in stones. Logically and statistically, to blame random mutations for cancer is like ascribing an increase in car accidents to more exhaust fumes rather than more traffic or driving. If the number of cell divisions and thus random errors were the culprit, there would be no elephants or blue whales – they have 100 and 2,000 times more cells and thus more random errors respectively than humans and yet rarely get cancer.
Moreover, emerging evidence indicates random mutations are not really random. A recent study published in the journal Nature by a team of international scientists shows organisms evolve to protect themselves and enhance survival rather than aimlessly drift.30 This finding directly contradicts the ‘bad-luck’ theory.
Do not blame the genes – they are doing the best to protect us but often become the victims of the changing environment.
Aging
Another smokescreen the cancer enterprise puts out is aging – more cancer cases because of the aging population. But why has childhood cancer incidence kept climbing? For example, the childhood cancer incidence rate (number cases per 100,000 population) in Denmark increased 75 percent from the 1930s to the 1990s. In the US, it jumped by 36 percent in 13 years from 1980 to 1993. And why are people diagnosed with cancer getting younger and younger? A recent study published by Harvard researchers have revealed the incidence of early-onset cancers like colorectal and 13 other types of cancer are rising rapidly in many middle- and high-income countries including the US,31 a study which has been widely covered by major news networks.
On the surface, older people are more likely to get cancer, but that does not mean aging itself is the cause of it – old people are at higher risk because, more likely than not, their body has accumulated more insults from environmental toxins and mental challenges (stress) in life, which, unlike aging itself, are modifiable factors. Aging per se might be an anticancer factor – older cells are better trained in what they do and they divide and grow more slowly – “Senescence is generally regarded as a tumor suppressive process, both by preventing cancer cell proliferation and suppressing malignant progression from pre-malignant to malignant disease.”32
When the members of the cancer establishment cannot find the fix, they find scapegoats – genes, and aging, which are not preventable or avoidable and therefore more money is needed to find cures.
Infections
That certain infectious organisms including viruses, bacteria, and parasites, can cause cancer or increase the risk of cancer is well established. For instance, Infection with HPV (Human Papillomaviruses) can cause cervical cancers, and EBV (Epstein-Barr Virus) can induce or contribute to lymphoma and cancers of the nose and throat. But most people carrying these viruses (e.g., about 90% of the population carry EBV) do not get cancer – the immune system, which is greatly affected by stress, environmental toxins and other factors, plays a critical role.
In addition, emerging evidence shows a different kind of infection called gut dysbiosis (overgrowth of pathogenic bacteria) is linked to cancer too, especially colorectal cancer.33,34
Although it is a fact that infectious agents can induce cancer, available data indicates they are not a major contributor. In other words, we will not get away from the specter of cancer by focusing on infections.
Environmental Toxins
As concluded by the large study on environmental and heritable factors published in the New England Journal of Medicine: “Inherited genetic factors make a minor contribution to susceptibility to most types of neoplasms. This finding indicates the environment has the principal role in causing sporadic cancer.”13
The Food We Eat
Our food, including grains, vegetables, fruit, meat, and dairy, is laden with insecticides, herbicides, fungicides, and other chemicals which are known to be carcinogenic. Animal products are loaded with antibiotics, growth hormones and other novel chemicals designed to increase production and profit. For example, it only takes about six months to grow pigs from birth to slaughter, and 6-8 weeks to grow chickens. Normal cows can only produce a gallon of milk a day, but the use of chemicals increases the production to six gallons a day.
As if these poisons were not bad enough, over 10,000 chemicals in at least 20 categories are added into our food by manufacturers for different purposes:35,36
- Anti-caking agents: Stops ingredients from becoming lumpy.
- Antioxidants: Prevents foods from oxidizing or going rancid.
- Artificial sweeteners: Increases the sweetness.
- Bulking agents: Increases the volume of food.
- Colors: Enhances or adds color.
- Emulsifiers: Prevents fats from clotting together.
- Food acids: Maintains the right acid level.
- Flavors: Adds more flavor.
- Flavor enhancers: Enhances flavors.
- Flour treatment: Improves baking quality.
- Foaming agents: Maintains uniform aeration of gases in foods.
- Glazing agent: Improves appearance of the food.
- Gelling agents: Adjusts the texture of foods through gel formation.
- Humectants: Keeps foods moist.
- Mineral salts: Enhances texture.
- Preservatives: Prevents microbes from multiplying and spoiling food.
- Propellants: Helps to push food from a container.
- Raising agents: Increases the volume of food by using gases.
- Stabilizers and firming agents: Maintains even food dispersion.
- Thickeners and vegetable gums: Improves texture and consistency.
Although the majority of these additives are safe, the health effects of many of them are unknown, and many are known to be carcinogenic. For instance, the artificial sweetener saccharin, which has been shown to cause cancer in animals, is still used in food and soft drinks.37,38 Nitrates and nitrites are two known cancer-causing compounds (mainly through reacting with other chemicals), but are still used to preserve processed meats.39,40 Potassium bromate is a possible human carcinogen because it has been shown to cause kidney, thyroid, and gastrointestinal cancer in animals. Although potassium bromate has been banned in Europe and many other countries around the world, it is still legally and widely used in many baked goods in the US to strengthen dough and allow it to rise higher, as reported in CBS Evening News on January 20, 2023.
Other similar toxic additives are azodicarbonamide (whitening flour), ractopamine (a popular feed additive for pigs and beef cattle to grow more muscle mass), titanium dioxide (makes food like candy, coffee creamer, baking and cake decorations more visually appealing), BVO (brominated vegetable oil used to keep citrus flavoring from separating out in sodas and other beverages), olestra (a fat substitute that adds no calories to products), propylparaben (food preservative), and the list goes on.
The unknowns are even more unsettling – the long-term health effect of countless food additives is unknown thanks to the GRAS (Generally Recognized as Safe) loophole in a 65-year-old law (the Food Additive Amendment signed into law in 1958) allowing food manufacturers to circumvent the approval process by FDA. As long as a food company deems an additive GRAS, no report to FDA is required.35,36
In addition to the chemicals directly added to food, dangerous chemicals in food-packaging materials also leach into food. Take for example, two known carcinogens, vinyl chloride and acrylonitrile, are still used in making food containers.38 And food manufacturers clean their equipment with hazardous chemicals which gets into our food too – this was exposed by the child labor scandal in the meat process industry which was widely reported in the news media early in 2023.
In addition to food, we also swallow tons of prescription drugs such as antidepressants and over the counter pills like ibuprofen – they are chemicals and often do more harm than good. In particular, chemotherapies themselves are in fact cancer makers.
This is not alarmist – the problem is not a single chemical – it is all the chemicals accumulating inside our body not for days or months but for years and decades.
The Air We Breathe
Overall, outdoor air quality in America has been getting better for the last decades. However, indoor air quality has been heading in the other direction – it has increasingly become a threat to our health. Residential houses have become more and more airtight for energy efficiency with very limited mechanical ventilation. Meanwhile, more and more synthetic materials have been getting into our homes, from building materials such as compressed wood boards and fire retardants (in carpets and padding) to household products such as cosmetics and cleaning products. In fact, it is hard to think of anything in our homes which is not synthetic or semisynthetic. All these chemicals and plastics emit toxic gases or particles into the air circulating inside our homes.
Indoor air can be very deceptive even if it is heavily polluted – colorless, smogless, and often odorless. One of the lurking dangers in our home is VOCs (volatile organic compounds) which are harmful chemicals emitted as gases from synthetic materials. Here is a statement from the EPA (Environmental Protection Agency): “Concentrations of many VOCs are consistently higher indoors (up to ten times higher) than outdoors. VOCs are emitted by a wide array of products numbering in the thousands. Examples include paints and lacquers, paint strippers, cleaning supplies, pesticides, building materials, and furnishings, office equipment such as copiers and printers, correction fluid and carbonless copy paper, graphics and craft materials including glues and adhesives, permanent markers, and photographic solutions.”41
A 2023 study published in Environmental Science & Technology revealed over 5,000 tons of VOC were emitted from consumer products in 2020 in California alone.42
It is well-known VOCs cause respiratory disorders such as asthma, bronchitis and allergies. But that is only the tip of the iceberg. The real danger is their invisible actions – they silently, stealthily, and slowly damage every organ and system of our body and contribute to almost every disease. Some of them are known to be carcinogenic. For example, formaldehyde causes cancer,43-45 which is widely used in countless products such as plywood, particle board, and oriented strand board (OSB, engineered wood similar to particle board) used in building homes (sheathing in walls, flooring, and roof decking) and making furniture. It’s also found in many consumer products like cosmetics, dish soaps, medicines, leather. And it is in the fabric of our clothing to give the permanent-press effect, increase stain resistance, and improve colorfastness.
Ironically, among all the manmade products in our homes, cleaning products including air freshers are supposed to keep us healthy, but their danger is often overlooked. Here is what American Lung Association tells us: “Many cleaning supplies or household products can irritate the eyes or throat, or cause headaches and other health problems, including cancer. Some products release dangerous chemicals, including volatile organic compounds (VOCs). Other harmful ingredients include ammonia and bleach.”46 Worse still, these chemicals released from cleaning supplies can react with other pollutants in the air to form other toxins which trigger illnesses including cancer.47-51
While manmade chemicals in the air endanger our health, not all natural substances are good either. Asbestos is one of them. Asbestos is a group of six naturally occurring fiber-like minerals which are soft, flexible, and heat-resistant. Because of its desirable properties, asbestos was once widely used in insulation and cement as well as consumer products such as cloth, paper, and plastics. Thanks to research revealing exposure to asbestos causes cancers and other diseases, the use of asbestos has become highly regulated.52
Nevertheless, according to the National Cancer Institute, up to 5,000 consumer products contained asbestos, many of which are still in use. Unlike many other chemicals, asbestos is stable and doesn’t emit into air by itself. But it can easily become airborne if old materials containing asbestos are disturbed. Asbestos is very nasty – once inhaled or ingested the mineral fibers become permanently trapped in the body and cause real damage to the lung and other organs. For anyone living in houses built before 1980s or handling old household items should be mindful about the danger posed by asbestos.
Asbestos has been banned in 55 countries worldwide, but not in the US. Like many other toxic chemicals, manufacturers put up a ferocious fight to stay in business. These companies made enormous profits by selling asbestos as insulation to shipbuilders during World War II and further expanded their business during the postwar building boom. They fought in courts with the help of unscrupulous researchers like J.C. Wagner who first identified the danger of asbestos and then changed his position to defend the asbestos companies in courts. Later it was revealed he was paid by these asbestos manufacturers.53 That is why asbestos was not phased out until 1980s and is still not banned in America.
Poor air quality is not just a problem in homes. It can be bad in office buildings too depending on the materials used in construction and how many synthetic products are placed for use in the buildings.54 In particular, thousands of indoor sports fields and playgrounds in schools and gyms around the country are covered with crumb rubber from recycled tires and plastics containing VOCs like toluene, polycyclic aromatic hydrocarbons, and other dangerous chemicals like phenylmercuric acetate that may be linked to cancer. These rubber floors also contain heavy metals like lead and mercury.
As the floors age and wear down, they release toxic particles into the air and become health hazards. This lurking danger came to the national spotlight after a 36-year-old PE teacher in New Jersey was diagnosed with rare kidney cancer in 2013.55
Finally, our skin, the largest organ of our body, is ‘breathing’ too. Poisonous chemicals in beauty products and sunscreens do get under our skin – they travel deep into our body and poison every tissue and organ and induce cancer.56 “Since 2009, 595 cosmetics manufacturers have reported using 88 toxic chemicals in more than 73,000 products which have been linked to cancer, birth defects or reproductive harm.”57
Among the beauty products, hair treatment products are among the worst. Two recent large studies funded by the NIH have found hair straighteners and permanent dye greatly increase the risk of uterine and breast cancer.58,59
Again, the problem for us is not a particular chemical – it is all the chemicals together and the many years of accumulation in our body.
The Water We Drink
If you think our drinking water is pure and wholesome, think again. First, where do all the runoff fertilizer and pesticides from residential and agricultural use go? Second, where did/do all the chemicals discharged from all the manufacturers go? Third, where do all the chemicals that end up in landfills go? Fourth, where do all prescription and over the counter drugs either discarded or metabolized go? Fifth, what contaminants are tested or not tested at your municipal water plant? Sixth, do you know most of the pipes carrying water from the treatment plant to your home contain lead? Finally, are the chemicals such as chlorine used by water plants for disinfection safe?
As to the first question, here is what USGS (United States Geological Survey), a government agency focusing on biology, geography, geology, and hydrology of the landscape, has to say, “Considerable increases in fertilizer and pesticide use began in the 1960s. In 2010, about 11 billion kilograms of nitrogen fertilizer and 300 million kilograms of pesticides were used annually to enhance crop production or control pests… Fertilizers and pesticides don’t remain stationary on the landscape where they are applied; runoff and infiltration transport these contaminants into local streams, rivers, and groundwater.”60
Nobody knows how much or how many synthetic chemicals producers and users have dumped into the environment since the 1940s. Among all the manmade chemicals discharged into the environment, the “forever chemicals” PFASs (per- and polyfluorinated compounds), especially its two family members PFOA (perfluorooctanoic acid) and PFOS (perfluorooctane sulfonate), have been thrust into the spotlight recently due to numerous incidents of widespread contamination and mounting evidence of toxicity.
PFAS, a class of over 4,000 different manmade chemicals including PFOA and PFOS, is truly ubiquitous – you can find them in hundreds of common household items such as furniture and carpet, water-repellent clothes, cosmetics, cleaning products, fast food wrappers, nonstick pans, paints, firefighting foams – they are detectable in the blood of 98 percent of us.
Of course, they are in our drinking water. In a recent report, EWG (Environment Working Group) stated, “Based on our tests and new academic research that found PFAS widespread in rainwater, EWG scientists now believe PFAS is likely detectable in all major water supplies in the U.S., almost certainly in all that use surface water… Of tap water samples from 44 places in 31 states and the District of Columbia, only one location had no detectable PFAS, and only two other locations had PFAS below the level that independent studies show pose risks to human health.”61
“I think it’s one of the biggest threats in drinking water that people don’t have a complete understanding of, and it’s been around for decades,” says David Andrews, PhD, a senior scientist at the EWG who was involved with the report.
In fact, the number of communities confirmed to be heavily contaminated with PFAS in the US continues to grow at an alarming rate – as of June 2022, 2,858 locations in 50 states and two territories are known to be contaminated.62
One of these locations is close to home – Hoosick Falls, a small town near Albany, New York, where I have lived and worked for 30 years. Despite the danger, nobody knew about the contamination for decades until Hoosick Fall’s resident Michael Hickey launched his own investigation into the town’s water supply since he was concerned about the high rate of cancer in the community. His father, John Hickey, died of kidney cancer in 2013. His father worked for decades at the Saint-Gobain Performance Plastics plant using PFOA, a member of PFAS, to make Teflon used for non-stick cooking ware.
In 2014, after searching the connection between PFOA and cancer he took samples from the town water and sent them to a lab for testing on his own dime. The results showed high levels of PFOA and caught the attention of the New York State Department of Health which ran further tests revealing PFOA levels as high as 600 ppt (parts per trillion) in sharp contrast to the EPA health advisory level for PFOA and PFOS at 70 ppt, the individual or combined level.63 And the tests also revealed the PFOA contamination reached 18,000 ppt in the groundwater near Saint Gobain plant and 21,000 ppt at a nearby dump site.
At long last, EPA has started to realize the gravity of the PFAS problem which extends far beyond the heavily contaminated sites. On March 14, 2023, for the first time, EPA announced the proposed National Primary Drinking Water Regulation (NPDWR) for six PFAS including perfluorooctanoic acid (PFOA), perfluorooctane sulfonic acid (PFOS), perfluorononanoic acid (PFNA), hexafluoropropylene oxide dimer acid (HFPO-DA, commonly known as GenX Chemicals), perfluorohexane sulfonic acid (PFHxS), and perfluorobutane sulfonic acid (PFBS). In the proposal, the limit set for PFOA and PFOS is 4 ppt, which is dramatically lower compared to the EPA health advisories recommended level of 70 ppt in 2016. Other four PFAS (PFBS, PFNA, PFHxS, and GenX) will be regulated as a mixture using a “hazard index.”
The proposed rule is now open to a period of public comments. EPA will take those comments into consideration for the final decision on the rule. “We anticipate that when fully implemented, this rule will prevent thousands of deaths and reduce tens of thousands of serious PFAS related illnesses,” stated EPA Administrator Michael Regan at a news conference announcing the proposal on March 14, 2023 in Wilmington, North Carolina. This sounds great – finally EPA is taking action. On the other hand, EPA just told us these chemicals had been killing thousands and sickening more but did nothing for decades.
Why did EPA drag its feet for so long while people are getting sick and dying? It is never too late, but it is still too little.
In addition to the chemicals for industrial use, chemicals used in homes are a problem too. Let alone the poisonous pesticides and cleaning products we use every day, the ingredients of all the common medications can also be detected in drinking water, which means the chemicals in the landfill (pills thrown away) and sewage systems (pills taken and metabolized) end up in the drinking water system.
The worst part is we don’t know what we don’t know. Municipal drinking water plants don’t test for these chemicals because they don’t know what to test for.
Municipal drinking water treatment plants indeed test for some of the heavy metals such as arsenic and lead. But the lead levels at homes could be very different from the levels at the water treatment plants because lead in the aged water pipes underground can leach out. That was the cause of the Flint water crisis in Michigan. Lead contamination isn’t unique to Flint – before lead pipes bringing water into homes were banned in 1986 nationwide, most water pipes underground were made of lead or at least contained lead. Lead pipes were used because they are stable, flexible, and rarely leak – they can reshape and adapt as the ground moves.
Finally, the lead problem will likely be gone thanks to the $1 trillion Infrastructure Investment and Jobs Act. But other problems remain.
An even more insidious problem is the collateral damage from water disinfection using chlorine. The implementation of drinking water disinfection and filtration is considered as one of the most important public health advances of the last century, which has effectively eliminated waterborne infectious diseases and poisoning. “But the use of chlorine has a dark side: In addition to inactivating waterborne pathogens, chlorine reacts with natural organic matter to produce a variety of toxic disinfection by-products (DBPs),” reported in the prestigious journal Science.64 Studies found an increased risk of bladder cancer after life-long ingestion of chlorinated drinking water.65-68 Even EPA accepted exposure to DBPs increased 2-17% of the bladder cancer cases.69
In addition to cancer, DBPs are also linked to other health problems such as birth defects.70-72 The health hazards of DBPs have since been well recognized worldwide. Unfortunately, the full scope of health problems caused by DBPs is yet to be uncovered. Scientists don’t even know how many DBPs are in treated water – at least half of the DBPs are unknown because chlorine is chemically so reactive it reacts with almost everything.68 Among over 600 DBPs that has been identified and reported,67 currently EPA only regulates chlorite, bromate, THMs, and HAAs (haloacetic acids).
Are we drinking a chemical soup? The answer is as obvious as 2 + 2 = 4.
* * *
The greatest manmade tragedy is the establishment refuses to accept two plus two equals four. They assert that the associations between chemicals and diseases are statistical correlations, not causations, which have not been proven by randomized controlled trials (RCTs), the only gold standard evidence the establishment can accept. But RCTs will never be done because we cannot deliberately expose thousands of people to toxic chemicals. And therefore, there will never be sufficient evidence to convict toxic chemicals of the crime. It is a perfect catch-22.
Another smokescreen the establishment loves to put out is “the study findings are inconsistent.” Of course, they are inconsistent – the studies are designed to produce inconsistent results. The prevailing analytical methodology is to ascertain the relationship between one chemical (e.g., Glyphosate or Roundup) and one disease (e.g., cancer). The problem is that the relationships between causes and diseases are multidimensional – one disorder is typically the result of multiple triggers working together (most often, it is the total toxic burden that matters), and one trigger can directly or indirectly contribute to different diseases (e.g., a chemical hurting the immune system could open the door for all kinds of maladies to infest). As a result, studies trying to pin down the relationship between a specific chemical and a disease will always reach inconsistent results depending on what other chemicals as well as other factors the study populations are exposed to.
To understand the root causes of the worldwide health crisis, we must collectively get out of the reductionist mentality – for the last 80 years, all kinds of chronic diseases including cancer have soared, but nothing else has changed much except for the environment – more and more chemical toxins. Not much of anything else to blame – we cut down fat intake, we reduced sugar consumption, and we exercise more…
Enough is enough. No more studies are needed to tell us environmental toxins are sickening and killing us. We don’t need RCTs to tell us we need to wear a seatbelt. And we do not need meteorologists to tell us it is raining outside. If you are still in doubt, just look at the pictures below, which are only 4 out of 21 pictures having the same trends with other diseases in the study published in 2014.73 And keep in mind, this is just one chemical!
Stress
Stress or psychological stress should not be blamed for the escalation of cancer and other chronic diseases for the last 80 years. Stress has been with us for millions of years – extreme weather, famine, epidemics, flesh-eating animals, wars, and loss of loved ones, just to name a few, all create stress. At the population level, there is no evidence the stress level has increased over the last 80 years; on the contrary, existing evidence shows it has decreased somewhat.74
Nevertheless, chronic stress is a real health killer – our world was not disease free 80 years ago – stress has been a killer for millions of years although we have only seen the scientific evidence in the last several decades. Hundreds of epidemiological studies have demonstrated stress increases the risk of getting cancer and dying from it as summarized by three meta-analyses.75-77 Furthermore, recent studies have also revealed stress promotes cancer growth and spread by interrupting the immune system, the neuroendocrine system, the sympathetic nervous system (SNS), gene expression, and the GI system (dysbiosis and leaky gut).78-84 Literally, chronic stress interrupts every system and function in our body and induces or contributes to almost every single disease humankind has ever suffered.
Stress and environmental toxins are the two greatest foes to our health, and their compounding effect is even more dangerous. Yet, we have collectively turned a blind eye on them – everybody seems to know stress and manmade chemicals are up to no good, but not many take serious actions against them.
The regulators, the public, and even our doctors have been conditioned by the medical establishment and industry interest groups to count on a pill for an ill. You see war on cancer – spending more and more money to chase the elusive ‘cure’. But you do not see campaigns against the two biggest cancer makers, stress and environmental chemicals – there are no patented pills to sell and there is no big money to make from prevention.
Micronutrient Deficiency
Mounting evidence shows a deficiency in micronutrients, such as vitamins B6, B9 (folic acid), B12, vitamin C, vitamin D, selenium, and zinc, increases the risk of getting cancer and mortality.85-93 Deficiency in micronutrients affects every function of our body. Especially, many micronutrients are cofactors for enzymes participating in detoxification,94 therefore a deficiency in any of them weakens our detoxification capacity which induces carcinogenesis. Furthermore, research also indicates deficiency in micronutrients can cause DNA damage (chromosomal breaks) leading to cancer,85,86 which is consistent with the findings that those eating more nutrient-dense fruits and vegetables have a much lower risk of cancer.
Sadly, the medical establishment dismisses the vital role of micronutrients in health based on the assumption micronutrient deficiency is rare or does not exist, which could not be further from the truth.
Despite fresh produce all year around in sparkling supermarkets and grocery stores illuminated with bright LED lights, not many people eat enough variety and quantity of fresh vegetables and fruits rich in minerals; instead, we rely too much on fast and processed food. And the problem is compounded by the decline of micronutrients in vegetables, fruits, and grains – soil has been depleted of micronutrients due to intensive farming with chemical fertilizers.95-97 For instance, a recent study shows a 49.1% decrease of copper, 50.2% of iron, 51.7% of sodium, and 9.7% of magnesium in fruit and vegetables in the UK from 1940 to 2019.95
It is true not everybody is deficient in every micronutrient, but it is also true not many are sufficient in all micronutrients. There are 17 identified essential minerals the human body can’t synthesize and must have: calcium, chloride, magnesium, phosphorus, potassium, sodium, sulfur, chromium, copper, cobalt, fluoride, iron, iodine, manganese, molybdenum, selenium, and zinc. Deficiency in any of them will do harm to our health. Are you sure you are not deficient in any of them?
The establishment has successfully indoctrinated the public with the falsehood of “malnutrition is a thing of the past or only in the Third World” by repetitively citing randomized control trials (RCTs) finding micronutrient supplements ineffective against chronic diseases. It is true most RCTs did not find dietary supplements effective. But there is a reason for that – it is due to the misuse of RCTs as discussed in the preceding article Reverse Autoimmune Diseases. Unfortunately, RCTs have been weaponized against anybody talking about root causes including nutrition deficiency.
Technically or rhetorically, the medical establishment is right – micronutrient deficiency is not a health issue for well-nourished people. But what does ‘well-nourished’ mean? Who is well-nourished and who is not? In a 2017 press release, the CDC reported “Only 1 in 10 Adults Get Enough Fruits or Vegetables.”98
Regardless, the medical establishment has succeeded in creating a reality where micronutrient deficiencies except for iron and calcium are not screened or treated in mainstream medical practice.
Regardless of RCTs’ findings, micronutrients are building blocks of our body – any deficiency is detrimental to our health. How many meaningful RCTs out there have shown eating more vegetables and fruit prevent cancer and other diseases? None. Thank heaven, the establishment has not told us not to eat more vegetables and fruits because of no conclusive evidence from RCTs.
We do not need RCTs to tell us to wear a helmet when riding a bike. For anybody who cares about health, please have your micronutrient status checked and take supplements if needed. Of course, do not over-supplement (most micronutrients are toxic if overdosed), and the best choice is to get all the nutrients from food.
4. The State of Curing Cancer
Is cancer curable? Unlike most other chronic diseases such as mental and autoimmune disorders which can be healed so long as the root causes are addressed, the cure for cancer has been elusive. It remains unclear whether cancer is a disease driven by active triggers or a result of irreversible damage of some body system. If it is the former, cancer is curable and all that is needed is to fix the root causes such as stress and environmental toxins. If it is the latter – the damage has been done, cancer is not curable unless it can be surgically removed or killed by chemo or radiology; even so, cancer can come back anytime if the root causes are not resolved.
If cancer is the symptom of irreversible damage of some body system, is it damage of DNA, the metabolic mechanism, or the immune system? Nobody knows – cancer experts fervently disagree on whether cancer is a genetic, metabolic, or immune disease.
If cancer is driven by active triggers rather than a result of irreversible damage of body systems, addressing the root causes should be effective. But unfortunately, that is not the case – only a few patients with metastasized cancer recover from alternative treatments addressing root causes.
This goes to show how little we know about cancer after 50 years’ war on it – we are shooting arrows in the dark.
Cure from Conventional Treatments
As discussed earlier, except for a few uncommon cancers, the reality is little progress has been seen for the last 50 years despite all the weaponry of surgery, chemo, radiation, targeted, and immune therapies. “The failure rate for drugs brought into clinical trials using such preclinical drug-testing platforms is 95 percent. The 5 percent of drugs that reach approval might as well have failed, since they prolong survival of patients by no more than a few months at best,” wrote Dr. Raza.7 This observation is firmly corroborated by a comprehensive assessment of chemotherapy efficacy: “The overall contribution of curative and adjuvant cytotoxic chemotherapy to 5-year survival in adults was estimated to be 2.3% in Australia and 2.1% in the USA.”99
For the last 50 years, we have heard a lot of ‘breakthroughs’, ‘game changers’, and glowing predictions. And we continue to see promising new drugs reported in medical literature and media (e.g., Dostarlimab-gxly was reported in 2022 to have a response rate of 100% for a type of rectal cancer).100 Unfortunately, the reality remains grim – cancer is still inflicting too much pain and suffering on too many.
Cure from Alternative Medicine
Although most alternative medicine practitioners maintain they can heal almost every chronic disease (rightly so in many cases), few of them even want to mention the word “cancer” let alone curing it, which goes to show the daunting challenges in treating cancer.
Can alternative medicine cure cancer? The answer is not black and white. In the past, there have been a few pioneers trying to cure cancer by addressing the root causes. Max Gerson, MD, was one of them. Dr. Gerson, a German-born American physician, developed the Gerson Therapy in the 1930s, a dietary-based cancer treatment therapy he maintained could cure cancer and most chronic diseases. He explained his dietary therapy, mechanics, and effectiveness in his book, A Cancer Therapy: Results of 50 Cases, which was first published in 1958 and now in its 6th edition (on Amazon, 82% of the reviewers gave a five-star rating and 2% gave one star).
Dr. Gerson and his therapy gained credence in the medical community in the early years in part due to the accolades he received from the 1952 Nobel Prize laureate Dr. Albert Schweitzer who was a believer of Dr. Gerson’s therapy. Dr. Schweitzer’s wife Helen suffered from lung tuberculosis for seven years while constantly seeking treatments without any success. She completely recovered from the disease by following the Gerson Therapy for nine months. Dr. Schweitzer also reversed his advanced diabetes with the Gerson Therapy.
The highest point for Dr. Gerson was probably his appearance with five of his cured cancer patients (supported by hard evidence of X-ray photographs and pathology reports from major hospitals) before a Congressional Committee in 1946 on cancer research and treatment. However, in the ensuing years, Dr. Gerson was vilified, and the Gerson Therapy was discredited for lack of rigorous scientific evidence,101,102 despite his achievement and exceptional credentials (graduated from a prominent German medical school and studied with noted physiologists and neurologists). In defending her father, Dr. Gerson’s daughter Charlotte Gerson accused the establishment of smearing Dr. Gerson, “Max Gerson, M.D. however, was unmercifully vilified, harassed, and persecuted in the United States by the AMA [American Medical Association], especially its journal [JAMA] editor, Morris Fishbein, M.D., and his physician-politician cohorts.”103
Obviously, the Gerson Therapy did not cure every cancer patient – taking all the evidence together, it’s fair to say the therapy is effective for a minority rather than majority of the cancer patients. But, that is true also and even worse for chemotherapy and radiology treatments still used today.
Regardless, Dr. Gerson was visionary. More than 60 years ago, he wrote “After more than 25 years of cancer work, I can draw the following conclusions: 1) Cancer is not a local but a general disease, caused chiefly by the poisoning of foodstuffs prepared by modern farming and food industry. Medicine must be able to adapt its therapeutic methods to the damages of the processes of our modern civilization.”104
He also wrote in the same book, “For the future of coming generations, I think it is high time that we change our agriculture and food preservation methods. Otherwise, we have to increase our institutions for mental patients yearly, and we will see the hospitals overcrowded with degenerative diseases even more rapidly and in greater numbers than hospitals themselves can be enlarged. Seventy years ago, leukemia was unknown in the United States. Fifty years ago, lung cancer was so seldom observed in clinics and autopsies that very case was worthy of publication. But today – what a change for the worse.”
Upon Gerson’s death, Nobel Prize laureate Dr. Schweitzer issued a statement: “I see in him [Gerson] one of the most eminent medical geniuses in the history of medicine. Many of his basic ideas have been adopted without having his name connected with them. Yet he has achieved more than seemed possible under adverse conditions. He leaves a legacy which commands attention and which will assure him his due place. Those whom he cured will now attest to the truth of his ideas.”
Unfortunately, the cancer establishment chose to look the other way. Rather than recognizing his vision and pioneering work, the establishment attacked Dr. Gerson by ridiculing the modalities of his therapy such as the coffee enema treatment which Dr. Gerson believed was absolutely essential to his therapy. In any case, Dr. Gerson’s quest for natural ingredients to cure cancer is not inferior to selecting poisonous chemical compounds to kill cancer cells and is no more unethical than the use of toxic chemicals.
The cancer establishment would argue the chemical compounds are first tested on animals while Dr. Gerson’s ingredients were directly used on patients. Well, who does not want to test new treatments, natural ingredients or not, on animals first? The problem is a catch-22 – the cancer establishment has monopolized nearly all research funds from governmental or charities for developing patentable manmade chemical compounds.
As a side note, you might wonder, does the cancer establishment really exist? What is it and how do its members conduct their ‘business’? Here is Ralph Moss, PhD, a cancer activist, wrote in his book The Cancer Industry:105
Is there really a cancer establishment? The term establishment was first used to describe the Church of England, and later the entire English upper class. If we understand the “cancer establishment” to mean some formally organized body, such as the hierarchy of a church, then clearly there is no such organization.
Nevertheless, the leaders of the top organizations discussed in this book are certainly familiar with each other and interlock on many committees, panels, and boards. Sometimes they are friendly, and sometimes they disagree. What holds them together, however, is a community of interests and ideas. The top leaders generally see eye-to-eye on the major questions concerning cancer. They favor cure over prevention. They emphasize the use of patentable and/or synthetic chemicals over readily available or natural methods. They set the trends in research, and are careful to stay within the bounds of what is acceptable and fashionable at the moment.
Without any doubt, there are many noble and talented individuals who dedicated themselves to cancer research and treatments. And it is hard to believe the interest groups and individuals conspire to profit over people’s health. However, we cannot deny the fact that money talks. Irrespective of whether the major players of cancer establishment conspire or not, here are the cold hard facts:
(1) Big pharma makes billions of dollars by patenting and selling drugs made of toxic chemicals. On the other hand, prevention and natural ingredients, which are not patentable, hurt their bottom line and could even bankrupt them.
(2) Even for researchers at university settings and supported by governmental funding (tax payer’s dollars), patentable drugs are irresistibly attractive – both the researchers and the institutions are richly rewarded with royalties whenever a patented drug gets on the market.
(3) It is well documented high-level players in governmental agencies like the NCI (National Cancer Institute) and FDA (Food and Drug Administration), in organizations like ACS (American Cancer Society), and in big pharma, enjoy the well-greased giant revolving door.9,10
(4) “There are currently 1,270 registered lobbyists for pharmaceuticals and health products – more than two lobbyists for every member of Congress.”106
Historically and at the present time, there seems to be an invisible hand at work – anybody promoting treatments with natural ingredients, regardless of his or her academic achievement and status, has been promptly ostracized and discredited. Even the mighty Linus Pauling, PhD, a biochemist, the only person in history who won two undivided Nobel Prizes, was cut off from NCI/NIH funding for research intended to demonstrate the effectiveness of natural ingredients such as vitamin C against cancer and other maladies.105
The consequence of the invisible hand is apparent – one can only find a handful of doctors who specialize in alternative treatments of cancer. And among the few who do, fewer still have not been sued or prosecuted for malpractice or other ‘misconducts.’ That is the irony – many thousands die each year under conventional treatments, but that is not considered to be a problem, since those practices are ‘state of the art’ and ‘gold standard’.
In fairness, the establishment is not all wrong – different levels of pseudoscience and even quackery do exist among alternative medicine practitioners. But painting all alternative treatments as quackery with a broad brush is unscientific – many treatments with natural ingredients are supported by scientific and clinical evidence. On the other hand, are all those ineffective chemotherapies used every day on cancer patients not a kind of equivalent to pseudoscience and quackery?
Regardless of the rivalry between mainstream and alternative medicine, neither of them has made a meaningful dent on the pain and suffering of the cancer patients and their loved ones. After 50 years of the war on cancer, the mainstream treatments still show little success with metastatic cancer. Although alternative treatments have some successes,107,108 they are few and far between.
Unfortunately, cancer, still a giant enigma, poses a seemingly insurmountable challenge to mainstream and alternative medicine alike.
Cure from Spontaneous Regression
Spontaneous healing of cancer, also called spontaneous regression, is a phenomenon that has been observed for thousands of years. After being a subject of controversy, it is now accepted as an indisputable fact and well documented in the medical literature. A search of PubMed shows over 7,000 articles on this topic.109-113 Spontaneous regression or remission (SR) of cancer is generally defined as the disappearance of the malignancies without any treatment. Apparently, the term “spontaneous regression” is a misnomer – there must be a reason for the regression – we just don’t know what it is yet.
In addition to the cases reported in the academic literature, since 1966 several books have also been written to explore this phenomenon.114,115 In particular, in her recent book Radical Remission, Kelly Turner, PhD, shared what she found from her study of over a thousand radical remission cases (those healed from cancer without any conventional treatments such as surgery, chemotherapy, and/or radiation). After interviewing hundreds of patients, Turner found nine common factors related to radical remission: (1) radically changing diet, (2) taking control of health, (3) following intuition (4) using herbs and supplements, (5) releasing suppressed emotions, (6) increasing positive emotions, (7) embracing social support, (8) deepening spiritual connection, and (9) having strong reasons for living.116
As to the change of diet, the majority of the patients she interviewed reported they greatly reduced or eliminated sugar, meat, dairy, and refined foods; greatly increased vegetable and fruit intake; ate organic food; and drank filtered water.
Overall, the nine factors can be grouped into three categories, which are instrumental: (i) reducing toxin intake (factor 1), (ii) managing mind or stress (factors 2, 3, 5-9), and (iii) avoiding deficiency in micronutrients (factor 4). This is no coincidence – they are the root causes of cancer as just discussed.
* * *
Taken together, although some cancer patients recover from conventional, alternative treatments, or spontaneous regression, sadly, cure is still the exception rather the rule once cancer has metastasized.
5. The Cure to Win the War on Cancer
The only weapon that can win the war on cancer is PREVENTION. And the cancer moonshot is reachable only if we launch a campaign to greatly reduce or eliminate environmental toxins.
Unlike other chronic diseases such as mental or autoimmune disorders which can be healed if the root causes are managed, reversing cancer is not a sure thing even if the root causes are addressed – very likely, hard-to-fix damage has been done once cancer reaches a certain stage. Even if cancer were treatable, let’s not forget the unimaginable suffering from the treatments – surgeries are disfiguring and even paralyzing, chemo and radiation damage vital organs and the immune system which sets up the stage for secondary cancer and other diseases, let alone the heart wrenching life altering decision on what treatment to take and the constant anxiety over if the cancer will come back.
Unless you want to play lottery on the cure, prevention is the best policy. Most if not all cancers can be prevented if the root causes are avoided – research on twins with identical DNA has demonstrated less than 10% of cancer is caused by genetic factors.13 In practice, the decrease of lung cancer incidence from reducing smoking is a shining example. To pursue prevention, it is imperative to understand this simple but profound fact: Our body does not malfunction for no reason – all diseases have root causes.
And we do know the root causes of cancer – mainly environmental toxins and stress (state of the mind) – no more research or randomized controlled trials are needed to tell us what causes cancer. For the last 80 years, all kinds of chronic diseases including cancer have been soaring, but nothing else except for the environment has changed much – we do not need meteorologists to tell us it is raining outside.
Addressing the root causes is more manageable than you think – there are four root causes and four causes only behind cancer – stress, environment, gut, and micronutrient malnutrition. If you need help, the book Road to Health provides guidance for each step you need to take.
Let’s not forget what Clifton Leaf, former editor-in-chief of Fortune magazine, has admonished us: No amount of money can end the cancer problem if more people keep developing the disease.
About the Author and Editor: Jian Gao, PhD, is a healthcare analyst/researcher for the last 25 years who devoted his analytical skills to understanding health sciences and clinical evidence. Mr. Frederick Malphurs is a retired senior healthcare executive in charge of multiple hospitals for decades who dedicated his entire 37 years’ career to improving patient care. Neither of us takes pleasure in criticizing any individuals, groups, or organizations for the failed state of healthcare, but we share a common passion – to reduce unnecessary sufferings inflicted by the so-called chronic or incurable diseases on patients and their loved ones by analyzing and sharing information on root causes, effective treatments, and prevention.
Disclaimer: This article and any contents on this website are informational or educational only and should by no means be considered as a substitute for the advice of a qualified medical professional. It is the patients and caregivers’ solemn responsibility to work with qualified professionals to develop the best treatment plan. The author and editor assume no liability of any outcomes from any treatments or interventions.
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