Charity Begins at Home

While eating my salad one evening at dinner, I happened to notice the following statement on the label of a bottle of salad dressing:

"Paul Newman and the Newman’s Own Foundation donate all profits and royalties after taxes for educational and charitable purposes. Paul Newman and the Newman’s Own Foundation have given over $200 million to thousands of charities worldwide since 1982."
http://www.newmansown.com/commongood.cfm

Well, this wasn't exactly what the label said but it is almost the same. Apparently, the label and the web site differ a bit as to the amount of money contributed (what's a measly 25 million anyway?). But, it made me start thinking about how many charities there are out there -- thousands? After doing a little research, I convinced myself, yes, maybe there are thousands of charities out there -- maybe even more than thousands. If you want to get some idea of the enormity of the non-profit world, you can go to http://www.charitynavigator.org/ and list all the charities they rate in alphabetical order. I am relatively sure all the charities they rate are not all the charities there are.

CHARITY BEGINS AT HOME -- "One's own family (or country, etc.) comes before any other responsibilities. The idea of the proverb can be found in the Bible (cf. I Tim. 5: 8, etc. If anyone does not provide for his relatives, and especially for his immediate family, he has denied the faith and is worse than an unbeliever.)."

"The proverb dates back to the time of the Roman comic playwright Terence (about 190-159 BC). In 1383, John Wycliffe wrote: 'Charity should begin at himself.' Five hundred years later Dickens said that 'Charity begins at home, and justice begins next door.' First attested in the United States in the 'Winthrop Papers' (1628).'." From "Random House Dictionary of Popular Proverbs and Sayings" (1996) by Gregory Y. Titelman (Random House, New York, 1996).

Recently, we learned one of our relatives was in dire circumstances financially and needed help. Many of our relatives donated money for food and housing for the mother and children of the distressed family. I'm thinking this is an example of how charity begins at home. It is also an example of the most efficient form of charitable giving and usage of charitable contributions. All the money went directly to the needy family with almost zero administrative "overhead" except for several long distance phone calls, postage stamps, etc. This is always the desired goal, that ALL the charitable contributions go 99.9% to those needing it. It seems the farther away from home the charity is, the less efficient the process becomes. Obviously, the most efficient transfer of charitable funds would be the personal exchange of money or some other form of aid which would result in zero overhead expense.

The idea of "begins at home" could conceivably extend out into the community and/or neighborhood you live in. It could also include the desire to help with the "overhead" costs. Some charitable organizations are supported with the intention of helping to cover the overhead expense. I give to our church every first day of the week with the intention of what I give being used to help with local ministry expenses, building upkeep and maintenance, and whatever else it might be needed for. I contribute to the local Salvation Army too. I don't know what their National Commander gets paid but I doubt it is anywhere near $500,000 a year.

Getting back to the thought above, thousands of charities. I view giving to charity somewhat like investing. I want the highest possible return for my investment dollar. The biggest BANG for the buck if you will. I bet you do too. My theory is that the more you "invest" in charitable giving close to home, the better your return on "investment." There are many, many "societies," "associations," and "foundations" you can give to that are administered by highly paid executives whose job it is to bring in the donations which sustain the organization (and themselves). These organizations for the most part do good work with varying degrees of efficiency.

Using the close to home principle, I tend to give to organizations which exist to help in some area which affects me directly in one way or another. I think most of us are pretty much motivated by a form of self interest, if you want to call it that, when it comes to charitable giving. In other words, if you have cancer, you tend to be interested in giving to charities which support cancer research in general and/or your specific kind of cancer (and there are over 200 kinds of cancer). Unless one is a multi-millionaire and/or a lottery winner, one can't really afford to give to all the charities, foundations, and societies that are out there needing money. We have to be selective because our resources are limited. We want our limited resources to have the biggest impact and in some small way, benefit us too. I suppose, in that sense, we aren't much different from the executives who manage the non-profits.

Big, nation wide societies and foundations solicit contributions from hundreds of thousands of people. Local organizations and family solicit from relatively few individuals. Therefore, I usually try to give the most to local organizations and family because the big organizations will pull in thousands of small donations the sum of which dwarfs any local effort I might involve myself in. Big organizations are also less efficient at delivering money that is contributed to where it is needed. Sometimes, the research or cause that is being supported turns out to be useless.

Often, big societies and foundations try to get close to home by moving into the community with community fund raisers. I don't really have a problem with that because it tends to draw attention to the cause and draw in donations that might otherwise not have been made. So even though the overall process is not as efficient as it could be, that is offset by the extra giving and increased public awareness not to mention the opportunity for excitement and gala social events.

Sometimes, you give to non-profit organizations and aren't really aware of it. Take for example the National Cancer Institute which is supported by your tax dollars. In a way, you are giving to charity and don't even know it or have any say in the matter except by personally contacting your representatives and/or volunteering as an advocate in one or more of the many societies or foundations which are involved in such. One example would be the Lance Armstrong Foundation http://www.livestrong.org/site/c.jvKZLbMRIsG/b.594849/k.CC7C/Home.htm

Lance is beginning to encourage the local community involvement approach by declaring Wednesday, May 16 "Livestrong Day." http://www.livestrong.org/site/c.jvKZLbMRIsG/b.1419713/k.917D/LIVESTRONGSTRONGstrong_Day.htm

Lance is trying to stop the cuts in government spending which have reduced the budget of the NCI over the last two years. I think we need to support Lance and the effort to influence Congress to increase government funding of the NCI. But it is difficult, to say the least, to focus on the "war on cancer" when the war in Iraq eclipses everything else!

With the advent of the internet with its personal web pages and e-mail, big national societies and foundations can help their participants get as close to home as possible. When my wife was pregnant with our daughter, she developed a complication involving the placenta which could have killed the baby if not dealt with appropriately. That experience lead my wife to become involved in the March of Dimes. Now, there is your paradigm of hope if your charity organization ever finds a cure. It is also a good example of a big national non-profit getting small in the neighborhood close to home.

Anyway, my wife went door to door soliciting donations for the March of Dimes to raise money to help prevent birth defects (not polio). At the insistance of the charity fundraiser directors, she would do this during super bowl weekend in order to catch people at home (not to mention the affects a couple of beers could have by half-time). Of course, this was in January so she had to be out in the cold trying to collect money. I don't think anyone enjoys being uncomfortably cold or going door to door asking for donations.

Well, my wife did all this because she believed in the March of Dimes -- until, one year, she learned that the March of Dimes was going to sponsor a big expensive awards dinner at the Governor's mansion. That lead her to investigate the March of Dimes' financials. She came to the conclusion that thirty percent or more of the contributions were going to overhead expenses. Remember what I said about the biggest bang for your buck. While my wife was hearing explosions out in the winter windy cold knocking on the neighbor's doors asking for money risking making a nuisance of herself, the organization executives were sitting in the warm comfortable Governor's mansion dining on expensive wonderful food. Needless to say, that pretty much eliminated the need to go door to door in the cold winter wind asking the neighbors for money any more.

Now, I'm not saying the March of Dimes is a bad organization and that they don't deserve your charitable contributions. The point is, prior to the internet, the only way to get up close and personal when soliciting donations was to mail letters or go through the neighborhood knocking on doors. Now, you can set up your own web page to accept donations and send e-mail directing your friends, family, and neighbors to contribute. Of course, you could still mail letters and go through the neighborhood knocking on doors if you wanted to.

Well, at the expense of Mr. Newman, I have pretty well wandered all over the place with the thousands of charities idea. Suffice it to say, there are lots of places to "invest" your charitable dollars. If you are more interested in efficiency, you should focus your efforts "close to home." If you don't have a problem supporting organizational overhead and maybe want to get involved in some of the socializing activities big national non-profits sponsor, go for it.

Harbenger of the Future

Following are excerpts from Dr. Guy B. Faguet's book, The War on Cancer An Anatomy of Failure, A Blueprint for the Future. This book can be located at Amazon.com as mentioned in a previous post.

I feel compelled to share this. I suspect none of what Dr. Faguet has to say will come as much of a surprise to some in the medical community. However, to me, it is like someone living today going back in time trying to explain what the interstate highway system will be like to someone living one hundred years ago. The concepts would be so foreign they would almost not be comprehensible. The concept of cell-kill vs. pharmacogenomics is a huge paradigm shift and is discussed in depth in the excerpts that follow. It is interesting to note the post about Mayo Clinic researching the possibility of wood mold to kill myeloma cells is of the cell-kill paradigm. Cancer knowledge has come a long way and has a long way to go yet as discussed below.

Note: This is a very lengthy post. If you are interested in learning more about the concept but don't particularly want to invest the time to read the complete post at this time, you can cut to the chase by scrolling down to the bold print where Dr. Faguet sums it all up in one sentence.
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Chapter 12

A VISION FOR THE FUTURE

Predicting the next revolution in cancer care is admittedly an uncertain undertaking but cumulative evidence of a system gone astray and nascent trends for correction are unmistakable. Until recently, researchers and their sponsors focused their efforts, and clinicians and their patients centered their hope more on the eradication of advanced cancer than on its prevention or detection in surgically curable early stages. This arose from the belief that cancer represents a seldom preventable, deadly tissue growth that is difficult to diagnose in early stages, is distinct from the host and, as such, must be eradicated. However, while surgery is adept at eradicating early-stage cancer, the types of cancer drugs fostered by the notion of non-self are inefficacious in altering patients' outcome, and the notion itself was proven obsolete by recent advances in cancer genetics. Additionally, it is increasingly clear that translational application of cancer genetics data is the foundation for the emerging pharmacogenomics of the future that will replace the trial-and-error approach of the past. Thus, the time has come to develop a new approach to cancer control based not on eradication at any cost but on comprehensive, stepwise, and evidence-based measures. They include prevention, early diagnosis, and, when these fail, on controlling the aberrant molecular genetic pathways underlying the development, growth, and dissemination of cancer (the caveat "when these fail" underscores the difficulties of controlling complex genetic abnormalities often associated with advanced cancer). Adoption of such broad-based cancer control measures requires a fundamental paradigm shift of such a magnitude and reach that its adoption and implementation is likely to be resisted by supporters of the old, cell-kill paradigm. Indeed, as Max Planck the physicist who postulated the quantum theory observed, "An important scientific innovation rarely makes its way by gradually winning over and converting its opponents ... Instead, opponents gradually die out and the new generation adopts the idea from the beginning". It might be argued that old hypotheses about the nature of cancer and theories about its treatment seemed cogent when first proposed and were proven wrong only in retrospect, and that the new paradigm might also lead us adrift. However, the inability of the old paradigm to explain most of the recent scientific tenets regarding the nature of cancer and its inadequacy as a foundation for spawning efficacious treatments can be neither redeemed, redressed, nor improved by any future discoveries potentially on its path. In contrast, the new paradigm is anchored on new scientific information regarding the nature, development, and progression of cancer and is supported by clinical studies that provide proof of concept of each of its component parts. Indeed, the crucial role played by prevention and screening on declining of cancer incidence rates recorded since 1992 was underscored in NCI' s 2001 Cancer Progress Report. It acknowledged, "Behind the numbers are declines in certain behaviors that cause cancer, especially cigarette smoking by adults. More people are getting screened for breast, cervical, and colorectal cancers". Likewise, the success of Imatinib mesylate, a drug developed to harness the molecular defect that causes chronic myelocytic leukemia rather than to kill the leukemic cells, and its success in the clinical arena provide proof of concept in support of molecularly targeted agents of the future. Thus, because it is sound in conception, based on scientific and clinical evidence, and of plausible implementation, the proposed new paradigm is likely to succeed in controlling cancer. Nevertheless, cognizant of the enormity of the task at hand and of the difficulties lying ahead my purpose is not to impose my vision for the future but to encourage a long overdue paradigm shift that is necessary to ultimately control cancer, whether or not it follows my proposal. The fate of over one million Americans who develop cancer each year, and millions more around the World, depend on it.


CONCLUSIONS

The War on Cancer was given impetus by the National Cancer Act of 1971, which tapped the vast resources of the Federal government to confront the growing cancer challenge. As a result, all cancer initiatives funded by Federal dollars have been channeled through the NCI; itself remade by the National Cancer Act. While proponents who anticipated the conquest of cancer by the nation's bicentennial were overly optimistic and patently unrealistic, this book reviews the achievements and failures of the War on Cancer in an objective and dispassionate manner, based on factual data published in mainstream scientific journals and other reliable sources. Over four hundred pertinent, easily retrievable, and verifiable references are cited in support of the author's core argument that the War on Cancer has been lost, and of his proposed three-part approach to cancer control as an alternative to the failed cell-kill dogma that dominated clinical research and patient care for decades.

First, we must acknowledge that the National Cancer Act of 1971 has had a profound and multifaceted positive impact on basic cancer research. However, translational application of our growing understanding of the nature of cancer to patient care has lagged far behind. Indeed, while our knowledge in molecular biology and genetics of cancer has grown exponentially in the last 20 years, patient care has improved only marginally despite the National Cancer Act. This is mainly due to neglecting prevention, undervaluing screening, and to our over reliance on inefficacious non­specific cancer drugs stumbled upon by serendipity or developed by a process of trial-and-error favored by the NCI, the main drug development funding source until recently. For example, molecular genetics is now poised to uncover the genetic defects underlying the emergence, growth, and dissemination of each of the more than 200 human cancers. In contrast, the 17 drugs identified by the World Health Organization as "essentiaf' to manage cancer were developed between 1953 and 1983. Less than a handful of drugs developed since then is having a meaningful impact on cancer care. As a result, in 2003 fewer than 24,000 Americans with mostly advanced hematologic or embryonal cancers, representing approximately 2% of all cancers, were cured of their disease by chemotherapy used alone or in combination with surgery or radiation therapy. In contrast, over 550,000 Americans died of cancer that same year despite receiving a variety of cytotoxic drugs, often to the very end. Of these, over 150,000 or 28% of all cancer deaths died of tobacco-induced lung cancer, the most lethal though preventable malignancy in the US and worldwide, after an average survival of 7 to 8 months; a figure virtually unchanged since 1973.

Thus, how are we to interpret reports of declining cancer incidence and death rates in the US after 1992 and of increased survival over decades? Is progress finally being made in cancer treatment? Unfortunately, the fall in incidence and mortality rates after 1992 did not extend beyond 1995 and 2000, respectively. Moreover, in 1997 fewer patients died of cancers with decreasing mortality rates (39% of total cancer deaths) rather than with increasing mortality rates (51 % of total cancer deaths), and 86% of the decline was due to reduced death rates in only 5 cancers. Additionally, factors other than treatment have contributed to lower mortality rates after 1992, and to increased survival over several decades. While the latter is due mostly to improvements in overall health care over time, the former resulted from public education campaigns that foster prevention via reduction in environmental and behavioral risk exposure, and early stage diagnosis via screening programs. Overall, fifty years of cytotoxic chemotherapy contributed minimally to the modest improvements in mortality rates or survival. This is because the faulty cell-kill paradigm, that views cancer as a "new growth" distinct from the host that must be eradicated at any cost, has misguided drug development and patient care for decades. From a treatment standpoint, surgery can satisfy this overriding principle because of its ability to remove early-stage cancer visually discernible from neighboring normal tissues, but current cancer drugs cannot given their non-specific mechanism of action unrelated to the cancerous process. This, in large measure, explains why innumerable attempts to enhance the efficacy of cytotoxic drugs, mainly via drug combinations and dose escalation with or without bone marrow transplantation, have failed to substantially increase cure rates or prolong survival for most cancer patients. That being the case, why does this failed system endure? The answer is multifaceted but can be summarized in one sentence. The information pipeline, generated by clinical researchers and supported by their sponsors and publishers, fosters standards of care that are reinforced by financial incentives and the extraordinary capacity of physicians for self-delusion, and by unrealistic expectations of consumers nurtured by the media.

Thus, the time has come to abandon the cell-kill paradigm and to anchor cancer control on an incremental, three-tier approach that incorporates prevention, early diagnosis, and when these fail, on controlling the aberrant genetic defects that lead to the development, growth, and dissemination of cancer. Is this approach likely to succeed where the cell-kill paradigm failed? It could be argued that, while found flawed in retrospect, past cancer control strategies seemed sound when first advocated, suggesting that the new paradigm I propose might also lead us astray. However, in contrast to hypothesis-driven past strategies the present proposal is solidly anchored on proof of concept for each of its components. Prevention has been validated by the success of anti-smoking campaigns in reducing the incidence of lung cancer in American males and by hepatitis B immunization programs in reducing the incidence of liver cancer in Taiwan. Screening programs to uncover cervical, prostate, and breast cancer in surgically curable early stages are saving lives, though screening tools at our disposable today are insensitive, non-specific, and confined to only a few cancers. Finally, the feasibility of controlling aberrant genetic defects underlying cancer rather than killing the affected cells has been amply demonstrated by the efficacy of Imatinib mesylate, the first specific, molecularly targeted anti-cancer agent of the post-genomic era. However, treatment of advanced cancer will remain at a disadvantage relative to prevention and early-stage diagnosis given the sheer size and greater genetic deregulation of such tumors. Ultimately, the success of the proposed measures will require a strategic shift from reliance on the conceptually faulty and implementally failed cell­kill notion of cancer treatment to a post-genomic cancer control paradigm. The new paradigm calls upon medical researchers to design means to identify and prevent cancer-causing agents, to develop simple, specific, and cost-effective screening tools for the early detection of all cancers, and to exploit the vast genomic database towards translational therapies for patients with advanced or progressive malignancies. It also calls upon policy makers to enact enlightened public policies towards cancer prevention and screening programs of national scope and achievable goals, and for the Nel to playa pivotal role in steering funding towards prevention, screening, and translational research. At the community level, it urges practitioners to focus on patient- rather than tumor-outcomes, to ensure that potential treatment risks are justified by the probability and magnitude of expected benefits, and to provide maximum pain reliefand comfort to terminal patients.

Mayo Clinic Discovers Wood Mold Toxic to Multiple Myeloma

ROCHESTER, Minn. -- Mayo Clinic Cancer Center (http://cancercenter.mayo.edu/) researchers have found that chaetocin, a by-product of a common wood mold, has promise as a new anti-myeloma agent. Results of their study are available online in the March 15 issue of Blood (http://bloodjournal.hematologylibrary.org/).

"This research is only the beginning," says Keith Bible, M.D., Ph.D., oncologist and the study's primary investigator. "But we are very hopeful that chaetocin may some day provide needed help to our patients."

Dr. Bible's team has shown for the first time that chaetocin has promising anti-myeloma activity. They found that chaetocin's promise includes the ability to:

• Kill myeloma cells harboring a diverse array of genetic abnormalities
• Cause biological changes and induce oxidative stress in myeloma cells, leading to their death
• Selectively kill myeloma cells with superior efficacy to commonly-used anti-myeloma drugs including dexamethasone and doxorubicin
• Reduce myeloma growth in mice
• Rapidly accumulate in cancer cells

"There were a number of fascinating findings," says Crescent Isham, Mayo Graduate School student and lead author of the study. "In addition to observing many favorable aspects of chaetocin, we discovered some avenues for further research into other possible anti-myeloma agents." She says researchers were surprised that chaetocin, while structurally similar to anti-cancer agents known as histone deacetylase inhibitors (HDACIs), did not, at cytotoxic concentrations, seem to function as an HDACI; but instead that the cytotoxic mechanism appeared to be at least in part attributable to oxidative stress caused by chaetocin.

"Much more research needs to be done," says Dr. Bible. "We will continue working with chaetocin to find the best way to use it for our patients. We are also pursuing other agents which may cause similar cellular oxidative stress." It will still be a few years before patient trials can commence, he says.

Mayo Clinic has a long tradition of leadership in myeloma research and novel therapeutic development, with the oldest and largest myeloma program in the country. Dr. Bible's research is part of an ongoing initiative within Mayo's Dysproteinemia and Myeloma Groups to find promising natural or man-made agents for the treatment of myeloma and other blood diseases; and to investigate at a basic science level and subsequently translate that research into clinical practice.

Other researchers contributing to this study included Jennifer Tibodeau, Ph.D.; Wendy Jin; Ruifang Xu, M.D., Ph.D.; and Michael Timm.

Funding for this research came from the National Institutes of Health and the Multiple Myeloma Research Foundation.

More information on hematology research at Mayo Clinic Cancer Center can be found on the Hematologic Malignancies Program Web site.

http://cancercenter.mayo.edu/mayo/research/hematologic_malignancies/index.cfm

SMOLDERING - 3/14/07

According to my quarterly serum electrophoresis test, my monoclonal protein level remains at 1.9 g/dl with total protein of 7.4 g/dl. My white blood cell count was somewhat higher which may have contributed to the 60% neutrophil, 30% lymphocyte relationship which means I was not neutropenic this time. I continue to count my blessings every day.

Here is a very interesting book I've been reading:

The War on Cancer: An Anatomy of Failure, a Blueprint for the Future (Hardcover)

http://www.amazon.com/War-Cancer-Anatomy-Failure-Blueprint/dp/1402036183/ref=pd_bbs_sr_1/103-7868638-8472604?ie=UTF8&s=books&qid=1173921713&sr=1-1

It is too expensive in my opinion ($169 new) but if you can get a "like new" copy ($50) it is close to reasonably priced. There is a lot of good historical information in this book which makes it worthwhile.

The first two thirds of the book deal with the failure aspects of the "war" on cancer and historical perspectives. The last third of the book deals with the blueprint for the future. Actually, the last chapter outlines what is needed for the future.

Basically, Dr. Faguet indicates that the current cancer industry is so laden with procedural and conceptual inadequacies, inefficiencies, and fallacies that it will take a new generation or two to develop more accurate genetic targeted tests, procedures, and treatments which should produce significant improvement in cancer prevention and survival. Furthermore, he indicates the scientific understanding of the genetic nature of cancer has already undergone an exponential increase which will begin to emerge as the aforementioned changes are made.