Length of Life vs. Quality of Life, Which Way Should Medicine go?

In general, modern medicine decision making in medicine today is geared to making people live longer.

Today we are going to discuss a presentation we heard at the AMMG conference in Tucson last October. The presentation was given by Dr. Angela DeRosa. Dr. DeRosa is the Medical Director of Belmar Pharmacy in Colorado.

Her presentation covered six main themes and we want to speak to you about several of them today, in particular, her concept of statistical homicide and her discussion regarding the evidence surrounding the Womens’ Health Initiative and how it relates to the current understanding of hormonal medicine.

One of the major thought- provoking issues in modern medicine is the concept that there are two different expectations facing physicians in regard to the goal of treating patients:  one is the goal of working toward a long life, disregarding the quality of a patient’s life. The other is the goal of a quality of life as our endpoint of treatment.

For example, if a patient has an aggressive lung cancer and there must be a decision made between treating her with a type of chemo that causes daily nausea vomiting and incapacitation, but offers a slightly longer life (an extension of less than a year), versus living half the time in fairly good condition until the last month of life. There are drug regimens that provide the first option are usually extremely expensive and offer longer life without quality. The second option is a slightly shorter life with more quality to connect with her loved ones before she dies.  In the past doctors were trained to pursue a longer life with no regard to the quality of that life.  In the recent past we began to wonder about the intelligence of that decision.  What would I do if I had the choice?

These are extreme examples and at BioBalance I have created a much different idea that does not make patients choose between length of life or quality of life.  The only requirement for me to treat a patient to achieve a longer life with quality, is some “lead time”…..I need to treat my patients before they get sick!

In general, modern medicine and all the research that is the basis for decision making in medicine today is geared to making people live longer.  The goal of medical research is keeping people alive….they consider it a “win” as long as that person is breathing, however impaired, or unable to care for herself.

The new paradigm is that of quality of life as the endpoint, keeping patients from being housed in nursing homes and from having to be cared for by their families.  To do that you need muscle mass so you don’t fall and so you can walk without a walker.  Quality of life means being able to connect to your spouse sexually, by keeping your libido for as long as you want and enjoy it. We are working on preventing Alzheimer’s disease by decreasing inflammation, diabetes and avoiding toxic substances that contribute to that disease. Dr. Derosa lectured on the same things I teach my patients every day.  She maintains that many of the guidelines for doctors regarding treating and diagnosing illness do not make any recommendations towards treating a patient to achieve optimal health, and therefore quality of life.

“Modern scientific medicine prefers laboratory measurements rather than assessing patient’s symptoms; regardless of the fact that it is the symptoms that make up syndromes.”

One of the syndromes that we treat every day is menopause. 1.1 billion women will be in menopause in the 2020. Medicine looks at menopause as one or two symptoms such as hot flashes and a dry vagina.   BioBalance Health® looks at menopause as a syndrome that changes women’s lives for the worse and impairs their ability to enjoy life and be productive. We feel it is important to treat women as if their mental capacity, physical health, and sexual life are relevant and important and that the best way to take care of these issues is to replace their sex hormones (estradiol and testosterone) that are lost to the changes occurring at menopause. If you replace these hormones to the same level of hormones you had in your thirties, you will age in a healthier and stronger way, maintaining your abilities to function and remain relevant and independent!

According to the Journal of the American Geriatric Society, you will hit menopause before you are fifty, and your life expectancy is about 80. Why should you spend thirty years of your life broken down and sick? We believe that you do not need to experience life this way and that replacing your lost hormones is the treatment of choice for maintaining strength, mental acuity, and independence throughout your life. This should be a Newsflash to mainstream medicine: Staying healthy with hormones keeps you from getting life-threatening illnesses! 

Menopause causes estrogen and testosterone deficiency.

The primary symptoms of estrogen deficiency are:

• Hot flashes
• PMS worsening
• Night sweats
• Irritability
• Dry skin
• Insomnia
• Depression
• Mood swings
• Forgetfulness
• Vaginal dryness
• Heart palpitations
• Increased allergies

The primary symptoms of Testosterone deficiency are:

• Low libido
• Weight gain
• Loss of focus
• Anxiety
• Depression
• Muscle pain
• Mood swings
• Sugar cravings
• Fatigue
• Belly fat

Dr. DeRosa presented information identifying the long -term consequences of hormone deficiencies, the same illnesses that I list in my book the Secret Female Hormone, among them:

1. Insulin resistance and diabetes
2. Cardiovascular disease
3. Osteoporosis
4. Dementias
5. Cancers

In her discussion of the data provided by the Women’s Health Initiative, she presented the concept of statistical homicide: “the triumph of long odds over common sense”.

Did you know that statistics created by medical researchers often try to make headlines and in doing so cause doctors to treat statistics rather than people.  Dr DeRosa calls this statistical suicide because it creates illness by following the statistics.

For example, in regard to the recommendation made by doctors that you should not go out in the sun because it doubles your risk of basal cell cancer.  However, they don’t tell you that it triples your risk of dying of heart disease.  Doubling risk in basal cell cancer (a non-deadly treatable cancer) goes from 2% to 4% but tripling your risk of dying of heart disease is much worse and would increase that risk by 300%.  Unfortunately, NOT telling you the second half of the truth causes you and your doctor to cause you more heart disease than if you didn’t use sunscreen!  I consider this practice medical lying.

Another way research is constructed to deceive is by “testing” a supplement and concluding that it is not effective, so people stop taking it. They do this by testing a small number of people on a dose that is so low it would never work.  Then the headline says, eg. “Vitamin E ineffective for treating Breast fibrocystic condition”. I bet none of the medicines people take would be proven effective if they were given in a very low dose either.

FEAR MOTIVATES US—EVEN UNFOUNDED FEAR and that is how medicine controls women, keeping them from taking the hormones they need to lead a healthy and productive life.

So, look at your daily life and the real risks therein: Medicine and journalism over -react to the misrepresentation of statistics in the news, so anxiety and fear creates a blanket of emotional upset and overreaction to those headlines that literally make us “sick”. The worry about hormone therapy in the minds of Americans ranked 14 out of 14! Dr. DeRosa claims that there is a medical war waged against women (and hormones) we want to share her slide on this:

The next point Dr. DeRosa made was to review the information about the faulty Women’s Health Initiative 2001:

The National Institute of Health wanted to assess the effect of Hormones on Cardiovascular Disease and breast cancer and spent 700 million dollars to do so. They included data on over 17,000 women ranging in age from 50-79. 2/3 of the women in the study were over 60. The trial was stopped early due to concerns about breast cancer and increased CVD risk. The data from the aborted study are still being evaluated but according to Dr. DeRosa, these are the findings in the data to date:

• A neutral risk of breast cancer in the PremPro (estrogens + progestin) arm of the study
• A decreased risk of breast cancer in the Premarin (estrogen) arm
• A decreased risk of CVD in women aged 50-59 in both (estrogen and estrogen+ progestin) arms of the study
• Women 10 years out from developing menopause greatly benefit from HRT (both hormones)
• Older women already suffering from CVD should use caution when starting hormones…but that is not the case with non-oral forms.

Our research and our experience treating post- menopausal women with bioidentical hormone replacement therapies leads us to believe that they are safe and will help you maintain your independence and health as you age and will greatly improve your health expectancy!

Other studies that killed women because the data that was misinterpreted.  The NIH decided 10 years ago that women over 40 don’t need mammograms every year, that every other year is enough.  I didn’t follow that advice because I compared it to my experience in gyn practice and remembered the women I had seen who had advanced breast cancer because they waited more  than a year between their mammograms!  The NIH doesn’t force doctors to do what they don’t agree is good medical practice, but insurance doesn’t have to pay for it if the NIH develops a protocol like this.

Most other doctors complied…that’s easier..but not for me.  It took ten years and thousands of lives for the NIH to retract their recommendation, but women died while they recommended a terrible medical plan form women. No one said they were sorry or compensated the families of the women who followed their plan and died.  It seems that if they scare women enough or recommend a treatment plan like not getting mammograms or taking hormones and women suffer.  I never see a plan for men to stop taking statins or stop getting stress tests.  It seems we don’t matter to the US government.

So don’t be manipulated by medical advice that skews data away from supporting healthy medical choices for women.  If it sounds illogical it probably is, so don’t follow their advice and talk to your doctor.  If he won’t listen, then take quote the mammogram advice and hormone advice given by the powerful NIH that eventually killed thousands of women.  Maybe that will get your doctor’s attention.

This Health cast was written and presented by Dr. Kathy Maupin, M.D., Bio-identical Hormone Replacement Expert and Author, with Brett Newcomb, MA., LPC., Family Counselor, Presenter and Author. www.BioBalanceHealth.com.