WILLIAM H. BESTERMANN
The current scientific paradigms that shape our view of chronic conditions are simply inadequate. Clinical medical scientists might think much more seriously about questions like these: Why is it that metformin reduces the risk of heart attack, stroke, and cancer while other drugs lower the glucose and do not protect from these conditions? Why is it that studies of patients treated with insulin suggest an increase in cancer? Why is it that a single dose of metformin or a statin-type drug reduces heart attack size by half in experimental animals? Why are patients who take certain medications for high blood pressure more likely to develop diabetes.
Today, basic scientists have laid the foundations to begin to answer these questions and the answers are important as we work to improve the quality of care. In practical terms, our scientific literature places little value on work that translates new science into practice. That is part of the reason that there is a large gap between what is known and what we do. This is the first of a series of articles that we hope will serve to help in closing that gap. The link between cancer and other chronic conditions is important. If we can reduce the risk of cancer even slightly by refining the way we manage other chronic diseases, then that is important work.
Another reason for this article and Urgent Science is a very personal one. Brian Klepper, the founder of CareandCost, has recorded the struggle that his brave wife Elaine endures with ovarian cancer now. I myself have been cured of a very aggressive type of lymphoma. How many of our friends and family have been struck down by these ailments. We need to improve our rate of translation. We invite you to read this first piece carefully and if you have refinements or additions that will help the broader medical community understand these problems better, we invite you to send us your constructive comments. We promise to take them seriously and use them to improve what we all know about the newest science and how it might be used to help our patients.
Bill Bestermann is a vascular physician at the Holston Medical Group in Kingsport, TN.