Wednesday 28 November 2012

Dr Henry Mannings and the GMC

There have been a number of reports in the press and on TV about Dr Henry Mannings and Star Throwers. I have written about Dr Mannings and his use of Coley's Toxins before. In my opinion he is above reproach and the case against him without foundation. The following is a statement that has been issued by Star Throwers, the cancer charity that Dr Mannings founded, and where I am glad to serve as a trustee.
Star Throwers would like to make it fully clear from the outset that we understand the purpose of the GMC Interim Orders Panel is to ensure patient safety, which we are in full agreement with.

Dr Mannings attended a GMC Interim Orders Panel hearing on Tue 27th November 2012, after which the GMC have concluded that there are no grounds for suspension. They have, however, decided to restrict Dr Mannings' prescribing of medication to within NHS premises only.

Star Throwers charity will remain open as usual, with Dr Mannings continuing to offer advice and support to cancer patients and their families.

The restriction is based on the allegations of one oncology consultant at one hospital, and is despite the fact that the two patients mentioned in the allegations had significantly benefitted from the therapy they had received from Dr Mannings. At no time have there been complaints from any of Dr Mannings’ patients or their families.

The loss of prescribing ability at Star Throwers is a loss to many of the patients who have been given up on by their own oncologist.

It is important to note that the IOP's decision is based "on the interest of patient safety" and has no bearing regarding any findings of fact or the veracity of the allegations.

Although we are not allowed to discuss the details of the Interim Orders Panel's decision report, we find the decision made by the panel difficult to understand considering the overwhelming evidence produced in favour of Dr Mannings, particularly by experienced senior oncologists, a professor of oncology, nurses and pharmacists.

We hope that there will be a full public GMC hearing, whose purpose is to decide the veracity of the allegations, within the next 18 months so that the true facts of this case will become evident.

Dr Mannings would like to express how touched he is by the hundreds of letters written and phone calls in support of Dr Mannings and all the staff at Star Throwers.

Monday 26 November 2012

In the PINC - stopping the reverse Warburg Effect

There was an interesting report recently on some work in the US looking at the use of a common anti-malarial drug and breast cancer. The drug in question is chloroquine, which is both cheap and widely used throughout the world. Aside from its action against the parasite that causes malaria, the drug is also known as an inhibitor of autophagy, which is a cellular state in which the cell digests parts of itself, normally as a survival mechanism in the face of lack of nutrients or damage to cell components. 

The study in question is called the PINC trial (Preventing Invasive Neoplasia with Chloroquine), which is specifically looking at women with ductal carcinoma in situ (DCIS), which is a pre-cancerous condition that is often picked up through breast screening. DCIS has the potential to progress to fully blown breast cancer. Part of the problem of the over-diagnosis of cancer associated with breast screening is that currently there is no way to be sure which DCIS lumps are going to become life-threatening cancer and which will remain harmless. The PINC trial is about treating women with DCIS who are waiting for surgery with chloroquine for four weeks and then to assess the effect this has on the DCIS lump. More details on the trial are available here:

While the trial has yet to report it’s findings, the initial signs are looking positive. If chloroquine can stop DCIS lesions from developing into invasive cancers that would be a major step forward for women. Stopping cancer before it develops is a much better strategy than simply turning every woman with a DCIS lesion into a cancer patient because you don’t know how the lesion is going to develop.

Tuesday 20 November 2012

Irreversible Electroporation

The three main arms of cancer treatments remain surgery, chemotherapy and radiotherapy - these still form the core treatments for most cancers. Arguably the set of treatments called ablative therapies should be added to that list. These include photodynamic therapy, cryoablation, and radio-frequency or microwave ablation. While these treatments work in different ways, they have some common features, they all:

  • physically attack tumours (with heat, cold, laser light etc.)
  • can be re-applied (i.e. resistance to treatments doesn't set in)
  • side-effects are local and easily controlled
  • are little used compared to surgery, chemo and radiotherapy

The last point is an important one, as these treatments have excellent safety profiles and can be targeted to achieve good rates of local control of tumours. The downside is that these treatments have to be applied to individual tumours rather than being able to systemically control widely spread disease. However, when used with other treatments these ablative treatments can make a huge difference to outcomes. As a bonus, for those with mutated tumour suppressor genes like TP53 (i.e. patients with Li Fraumeni Syndrome), there are no unwanted long term risks of other cancers due to DNA damage in surrounding tissues.