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Medical Forum / Diseases and Disorders / Alzheimer's / August 2006How Optimistic Are You?
I'm just curious, and I'm looking to get some other opinions from this group and maybe stimulate a good debate: how optimistic are you out there that (a) Alzheimer's will be cured, and (b) the cure is relatively imminent? My wife is being treated by a relatively senior neurologist in the AD community in Boston, a chief of service at his hospital and a member of the teaching staff at Harvard Medical. In other words, one could expect that this guy has some idea of what he's talking about. At her May visit, he told us about a paper that had been presented at a symposium he had attended. The theme of the paper was "The cure for AD is already in someone's test tube." In other words, previous research had progressed to the point, and current research was focused enough, that statistically the presenter was sure that some approach currently being investigated would turn out to be the cure. At her July visit just a few days ago, he said further that conventional widsdom in the medical community is putting the cure at 2 to 5 years away. My wife's primary care physician and a director at the local chapter of the Alzheimer's Association are being similarly optimistic, although varying somewhat in the numbers, when we speak with them. Is anyone else hearing this kind of optimism? Or should I ask our neurologist for a couple of ounces of whatever it is he's been smoking? TIA, Alan > I'm just curious, and I'm looking to get some other opinions from this > group and maybe stimulate a good debate: how optimistic are you out there > that (a) Alzheimer's will be cured, and (b) the cure is relatively > imminent? a) very b) not for another 20 years plus. with the provison that 'cure' means prevention. I very much doubt fixing people with Az, except possibly the very earliest stages, is ever going to be possible. For the very good reason that; 1) no one really actually _knows_ the cause. 2) once you know the cause you have to come up with a cure 3) the cure must not have side effects. 4) testing a cure and being sure it is, takes ages 5) especially when its preventative..you might have to wait 10 years to be statistically sure > My wife is being treated by a relatively senior neurologist in the AD > community in Boston, a chief of service at his hospital and a member of [quoted text clipped - 7 lines] > presenter was sure that some approach currently being investigated would > turn out to be the cure. yep, and its a _long_ way from a lab to a medicine that works. a very long way. >and further that conventional > widsdom in the medical community is putting the cure at 2 to 5 years away. if by 'cure' you mean, available to all, not a chance. If the cure was discovered _today_, it would still be 10 years away from being really available, and as it hasnt been, add discovery time onto that. And every single investigation with Az prevention, lets say giving it to early stages patients, takes 2 to 3 years before you can see an results. > My wife's primary care physician and a director at the local chapter of > the [quoted text clipped - 6 lines] > TIA, > Alan Yep  SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com >> I'm just curious, and I'm looking to get some other opinions from this >> group and maybe stimulate a good debate: how optimistic are you out there [quoted text clipped - 55 lines] > > Yep I don't like to sound negative, but I would tend to agree with what Tumbleweed said above. On the more positive side, the most recent alzheimer drug was released rather quickly, but it was already made available in Europe long before it was in the pipeline for release here. If they had some kind of a cure, I would think there would be an outcry to speed up its release more quickly than usual, since this illness is so devastating to families. All the drug companies are extra careful about new medications being released because of lawsuits. SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') I think your estimates are certainly realistic, Tumbleweed. Even if a cure does become available soon, or if someone already has the cure it in a test tube....the pharmaceutical companies will make the price so high that it will be out of the reach of alot of the people who really need it. It's already happened with many drugs, including Aricept, Excelon and Rimadyl. The province that I live has a drug plan for Seniors...the drugs it covers are selective...and it does not cover the cost of drugs for Alzheimer's patients. I called the Gov't and asked why?...It would seem to me that this family of drugs would be first on the list because ALz disease is a disease that primarily affects our Seniors.....and it just makes sense that they be covered under our "Seniors Drug Plan"..... I was told they are not on the list because they are too expensive. Their cost puts them out of reach for many people who need them...and apparently even out of the reach of my provincial government.. Then there are those who believe that there is already a cure ... my BIL is an MD with a pharmacy degree and has interests in a research aspect. He says that pharmaceutical companies are scum...he knows of situations in which researchers have had their funding taken from them when they were thought to have gotten too close to cures for specific diseases...the research community already has cures for many types of illnesses...problem is should the pharmaceutical companies make that kind of information, and the drugs, available they would lose billions and billions and billions of dollars. So, although I do think your predictions are realisic and reasonable... I think that any optimism regarding a cure is best tempered with knowledge of the immense power that these companies hold.... the "Big Bucks" pharmaceutical companies spend, or don't, on both researchers that they fund, and Governments that they lobby, plays a role that is probably alot more influential than we even want to know about. It all comes down to the almighty dollar. Torpedo. >> I'm just curious, and I'm looking to get some other opinions from this >> group and maybe stimulate a good debate: how optimistic are you out there [quoted text clipped - 55 lines] > > Yep >I think your estimates are certainly realistic, Tumbleweed. > [quoted text clipped - 32 lines] > > Torpedo. Sad to say, but I think you are right. Some diseases are very profitable, and a cure might spoil that for them. SignatureBest Regards, Evelyn (to reply to me personally, remove 'sox') I have been hearing of a new drug for diabetes ...That will actually clear the damage from the alzheimers patient....called ''Avendia''' I have been hearing of a new drug for diabetes ...That will actually clear the damage from the alzheimers patient....called ''Avendia''' ------------------------------------------------------------------------------ Easter Stephens Easter, Avandia is not a new drug. It's been around a long time. -- Best Regards, Evelyn (to reply to me personally, remove 'sox') > Then there are those who believe that there is already a cure ... my BIL is an MD with > a pharmacy degree and has interests in a research aspect. He says that pharmaceutical > companies are scum... I agree with all of that. The purpose of a drug company is the same as the purpose of a car company, a clothing company a computer company, or any other company. It's purpose is not to make drugs, but to make money. The drug companies spend vastly more money on marketing than on research and drug development. And the research and development they do is targeted towards the drugs and techniques that will make the most money. It sickens me to see ads on television for drugs - often for drugs that are less effective and or far more dangerous, than inexpensive drugs that have been around for years. It sickens me to see drugs priced at 10, 20 or 50 times the manufacturing cost, ostensibly to finance research, but really to pay for more marketing and to line the pockets of the stockholders and the management. Developing and pricing consumer goods to make the most profit seems fine to me. But developing and pricing drugs, especially under monopoly patenting conditions, sucks money out of sick people and their families and produces dismal outcomes for all people. Alan >>Then there are those who believe that there is already a cure ... my BIL is an MD with >>a pharmacy degree and has interests in a research aspect. He says that pharmaceutical [quoted text clipped - 24 lines] > out of sick people and their families and produces dismal > outcomes for all people. Sing it. The old truism "A man cannot serve two masters" comes to mind. The pharmaceutical industry does not, *cannot*, serve the best health of the consumer, because it *must* -- by law and ethics and everything else -- serve its shareholders. That means, among other things, lots and lots and lots of drugs to "treat" things, and almost no actual *cures*. "My disease may not be fatal/But I can ease my fears/By taking two twelve-dollar pills/Each day for fifty years! I've heard rumors -- have no idea how true it is -- that the real reason Bush vetoed stem cell research was not out of any religious conviction, but rather because Big Pharma put on the pressure. They don't want stuff like diabetes, Parkinson's, or Alzheimer's cured; they'd lose too much money. Dana >It sickens me to see drugs priced at 10, 20 or 50 times the >manufacturing cost, ostensibly to finance research, but really >to pay for more marketing and to line the pockets of the >stockholders and the management. And to buy off our politicians. >>It sickens me to see drugs priced at 10, 20 or 50 times the >>manufacturing cost, ostensibly to finance research, but really >>to pay for more marketing and to line the pockets of the >>stockholders and the management. > > And to buy off our politicians. Yes, politicians, medical community "thought leaders", FDA managers, ordinary doctors, newspaper editors, etc. According to Marcia Angell's _The Truth About the Drug Companies_, the top 10 U.S. drug companies in the U.S. in 2002 made more profit than all of the rest of the 490 Fortune 500 companies in the U.S. put together. And at the same time, the amount they are spending on research is dwindling (they license it from NIH sponsored researchers), and the number of innovative drugs they produce is in sharp decline. Only 7 of the 84 drugs approved in 2002 were considered "new molecules" which had better treatment outcomes than the standard drugs in their category. Not one of the seven was developed in a drug company research facility. I'll make a separate posting about this sometime. Alan Tumbleweed, Excellent points. Alan, remaining optimistic and hopeful is good. There are times while caring for a LO with AD that being optimistic and hopeful carries us a long way during the harder times. Being realistic is even better. It keeps one from being severely disappointed when what we dreamed about (miracle drugs/cures etc) doesn't happen. Best wishes for you in caring for your wife. Susan > > I'm just curious, and I'm looking to get some other opinions from this > > group and maybe stimulate a good debate: how optimistic are you out there [quoted text clipped - 58 lines] > email replies not necessary but to contact use; > tumbleweednews at hotmail dot com Lets put it this way - I'm 50 this year, and I'm hoping they have something ready to go for when I hit the 70 plus danger years - and I think that is a realistic thought - but I wouldn't hold my breath for anything even in the next decade. They keep saying they are on the trail of something, but then it doesn't pan out, or it helps a bit, but not to the extent hoped.Even if today, they were absolutely sure they understood the causes of the illness, and the mechanisms by which it progresses - it would still take years to translate that into drugs to either prevent the problem or stop the damage. There is always a big gap between theory and practice, and even a good answer needs endless fine tuning and trials to bring to market. After all, there have been instances where there are meds whose unexpected side effects cause problems worse than the disease they are supposed to treat. Mary G. > Lets put it this way - I'm 50 this year, and I'm hoping they have > something ready to go for when I hit the 70 plus danger years - and I [quoted text clipped - 15 lines] > > Mary G. in today's insanely litigious 'its always someones fault' society in the US, often it seems that almost any side effects are enough to get a drug withdrawn. I think there was a heart drug recently that was taken off due to (an incredibly low level of) side effects, way below (from what I recall reading) the good it did. SignatureTumbleweed email replies not necessary but to contact use; tumbleweednews at hotmail dot com Tumbleweed, I think I followed all of your arguments, but I want to hone in on one point: are you saying that you believe that eventually they'll be able to prevent people who don't have AD from getting AD, like with some sort of vaccine, but you don't believe they will ever produce something that will rid people who already have the disease of it? I'm thinking of drugs like AAD-001, currently in Phase IIa testing, which supposedly not only prevents the accumulation of beta amyloids but also removes the beta amyloids which are already there. Or is it that you believe the damage done by AD is irreversible, so that the "best" (if you want to call it that) that a medication could do is prevent further decline but not regain any already lost ground? Quite frankly, I discussed that possibility with a researcher at Brigham and Women's in Boston a few weeks ago, and we both had cold chills at the thought of some of the ethical implications that implies. That part I leave as an exercise for the reader... Regards, Alan > I'm just curious, and I'm looking to get some other opinions from this > group and maybe stimulate a good debate: how optimistic are you out there > that (a) Alzheimer's will be cured, and (b) the cure is relatively > imminent? > ... My sense of the future is pretty much in accord with what Mary and Tumbleweed and others have said. In 20 years - yes, we'll have something. Before then, maybe, maybe not. It's hard to tell. Unfortunately for me, I'm 60 already, so whatever happens could be too late for me. But I will strike one note of optimism. I've gotten interested in the science of biology as a hobby lately and have been reading a lot - including a lot of molecular biology. It turns out that progress in molecular biology has been accelerating steadily in the last several decades. Research tools and techniques keep improving. As they improve, we learn more. As we learn more, we improve the tools and techniques, and so on. Analysis of gene structures that took months of painstaking manual labor a decade ago are now done in an hour, completely automatically, by a machine. Figuring out what a gene or a protein does - which could take 10 years of very hard experimentation a decade ago, can often be done in minutes by a computer program that searches a database for close matches on gene or protein sequences with sequences that have already been analyzed, finding matches that no human would have noticed. And as the databases get bigger the number of matches gets greater and the amount of new data going into the databases increases - in what we might call a virtuous circle. Compared to molecular biology, rocket science is easy! But in spite of that, we're advancing our knowledge faster and faster. So, although I'm afraid to get my hopes up too high, I'm not altogether pessimistic even for the next 5-10 years. For me, if I get signs of AD and there are experimental treatments that look like they're on the right track, I won't wait 10 years or more for the treatments. I'll sign up early for the clinical trials, if I can, and take my chances. (Another) Alan |
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