Breast Cancer Awareness Month Fails to Disclose Limitations of Mammography by Jeffrey Dach

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October was Breast Cancer Awareness Month, which is an advertising campaign for national mammography screening. An eminent radiologist, Leonard Berlin MD says this message fails to disclose the limitations of screening mammography, namely that mammography will miss 30-70% of breast cancers, and leads to over diagnosis and over treatment. He also says mammography disclosures should be mandated, just like the cigarette and drug warnings that appear on their ads.

Otherwise, we create unrealistic expectations for mammography which cannot be met. The public expects every breast cancer to be detected. They are not. This translates into increased medical malpractice payouts for the missed cancer, which is now the most prevalent medical malpractice case against all physicians. (1) (1A) (1B) (2) (3) (4)

The fact is that mammograms are difficult to interpret, cancers can be hidden, and many are missed. This cancer miss is not from lack of training or competency on the part of the radiologist. It is inherent in the mammogram technique itself.

The American College of Radiology says that 30-70% of breast cancer are missed on the initial mammogram, and are seen in retrospect a year later by going back to the previous mammogram interpreted as normal.With this legal environment, it is a miracle that mammography has survived at all.(5) (6)

Screening Mammography is Not Prevention.

Leonard Berlin points out that 57% of the American women believe that mammograms prevent breast cancer, a misleading message from Breast Awareness Month. (1B) Mammograms are designed to detect cancer, not prevent it. Thinking that a mammogram can prevent breast cancer is like thinking that checking your house annually for broken windows, prevents robberies.

Secondly. the most likely outcome of a positive mammogram is an unnecessary biopsy, causing emotional distress, breast deformity and scarring. 80% of all breast biopsies done for a positive finding on a mammogram are negative for cancer. (5)

My Own Experience with Mammography

When I began residency training in radiology at Rush Presbyterian Hospital in Chicago in 1971, the state of the art was Xeromammography. This was a machine made by the Xerox Company which was prone to mechanical failure, and always breaking down. It produced a blue photo on paper with blue toner powder. (27) (29)

Example of Xeromammogram

Example of X-ray Film Mammogram

In those days, Franklin S Alcorn MD, was the only brave soul willing to read the Xerox images, and the book was Xeroradiography by John N. Wolfe. In 1972, the consensus in the department was that mammography was an orphan procedure and might never become acceptable. Some docs thought xeromammography was bordering on quackery, and screening mammogram had not been invented yet. (30)

Useful to the Surgeon

In those early days, the surgeon's criteria for doing a breast biopsy was a palpable mass. Many women have palpable lumps and bumps called fibrocystic breast disease which is quite common, and now known to be caused by iodine deficiency. (7)

Cyst or Solid Breast Mass?

In those days, the surgeon approached a breast mass with needle aspiration to differentiate between a fluid containing cyst or a solid mass. Nowadays, ultrasound determines this easily.

Back to the needle aspiration procedure; if the lesion is a cyst, the fluid is removed and the mass disappears. If no fluid can be obtained, then the mass is solid, and surgical removal is the next step. This is where the surgeons found the xeromammogram useful, occasionally showing a second occult mass or calcification which alerts the surgeon to remove additional tissue.

Invention of Needle Localization

Sometimes the surgeon had trouble actually finding the tiny calcifications at surgery since they couldnt feel them, so needle localization was invented. The radiologist placed a needle in the breast tissue near the calcifications which guided the surgeon to the spot to be removed. The surgically excised breast tissue was returned to the X-ray department for another mammogram of the specimen to determine if the lesion had been removed (see below).

Example of excised specimen with needle localization (done for calcifications)

Example of Needle Localization for spiculated mass typical for malignancy in specimen.

The Switch from Blue Paper to Gray Xray Film

Grey X-Ray film mammograms replaced the blue Xerox paper images around 1982. By that time, I had joined a radiology group in Hollywood, Florida, but they were still using the xerox machine even though the whole country had already made the switch to regular x-ray film. This inevitable switch-over to X-ray film made possible the large scale national breast screening programs, since the mammogram could be done at any hospital x-ray department. (27)

Finally, We All Learn Mammography

My radiology group made the plunge into film mammography. None of us had prior training or experience reading mammograms, so we traveled to expensive meetings and teaching courses on mammography from leaders in the field, such as Marc Homer MD and Laszlo Tabar MD (Sweden), and then we started reading on our own. (8)

From Breast Needle Biopsy to the Creation of a New Department

Soon we were doing the needle localizations (using the Marc Homer needle) and needle biopsies in the radiology department. Initially, biopsies were done with simple supplies, a standard 20 gauge needle and 10 cc disposable syringes. A few years later, the radiology industry came out with spring loaded and vacuum assisted biopsy guns, and later invented dedicated biopsy tables using stereo-tactic guidance. This machine allows the operator to take two x-rays at different angles, and uses a computer to calculate the exact position for the biopsy needle.

By 2005, the cranky unreliable blue toner xeromammogram had been replaced with a shiny new department on the third floor with all the new modalities: hi-resolution digital mammography, stereotactic biopsy, breast ultrasound, and breast MRI. There is no question that the combination of these modalities makes a powerful and useful tool for diagnosis, treatment and follow up of breast cancer cases. However, this is quite different from screening mammography which is discussed below.

Victimization of Women?, No, Merely Good Medical Care.

When we started the screening mammogram program, many of the suspicious findings were false positive meaning they looked like something, but were in fact nothing. The radiologist would send a report of "suspicious requires biopsy" to the doctor who would tell the patient it might be cancer, and the terrorized woman would then not only submit to surgical biopsy under anesthesia, she would become hysterical and insist on the biopsy immediately. The negative biopsy would be a relief to the patient making the surgeon a hero. Feminists call this victimization of women, and healthcare professionals would call this good medical care.

Occasionally, about 10-20% of the time, a real cancer would be found at surgery. These were typically spiculated masses or branching tell-tale calcification patterns. In the early days, the punctate calcifications and the milk-of calcium (teacup) were called benign and did not require biopsy, and the branching calcifications indicated malignancy requiring biopsy and further treatment, However, nowadays, even the benign calcifications are routinely sent for biopsy, sometimes showing a controversial non-aggressive cancer called DCIS. (9) (10)

What's Your Track Record ?

At first, we had no idea how many of our mammogram readings of suspicious for cancer were actually found to be cancer by surgical biopsy and pathology evaluation. So, we started compiling the pathology data and attended monthly conferences to review the data and our track record. The average is one cancer every 5 biopsies, but each radiologist and hospital may have more or less. Optimally, this information should be posted on the wall of the waiting room. Unfortunately, this type of data is rarely available to the patient.

Questioning Screening Mammography

In the 1980s I believed, along with every one else in the health care industry, that mammography was capable of early detection of breast cancer, and that mass screening programs were capable of reducing breast cancer mortality. I even wrote a short editorial that appeared in the Miami Herald to this point which won the praise of my associates at the hospital.

Starting around 1995, however, I began to question the idea of screening mammography. Even from the beginning, there was a debate between proponents and critics of mammogram screening. They argued that the studies either did, or did not show reduction in breast cancer mortality. The critic, Samuel Epstein says mammograms cause harm from overtreatment with unnecessary breast biopsies, and the radiation increases breast cancer risk.

Luck of the Draw - Mammography Malpractice

One of radiologists in my group had the misfortune of being sued for malpractice. He missed a cancer on a mammogram that was visible in retrospect a year later. Remember, this happens 30-70% of the time, routinely.

This event happened early in his career, just out of training, before I joined the group. His insurance company quickly settled the case by paying the woman a settlement of a million dollars, with no attempt at defending the case. As you can imagine, this was a major event which changed how he interpreted mammograms. After that, he was gun shy, almost always did a callback for additional views, and always recommended biopsy for any vague density. The problem is that almost every mammogram has vague densities. Almost all of these biopsies were unnecessary for the patient, but they were quite necessary for the radiologist, considering the medico-legal climate.

The x-ray techs quickly learned to bring the mammograms over to my reading area for a quick negative, rather than to the other reading room, where they usually end up doing more views and send the patient for biopsy of a questionable area. This went on for years, and I was never sued for malpractice on a mammogram reading during my entire career. I consider this "the luck of the draw".

Realizing the high rate of false positive biopsies and the emotional impact on women, I did my best to call the negative mammograms negative realizing there could be a cancer hiding somewhere, and the visible cancers were sent to biopsy.

Biopsy Everything and Anything

The reality of a hostile medico-legal malpractice climate and financial pressure dictates the practice of mammography in most community hospitals. Current practice is to basically biopsy anything and everything that shows up on the mammogram, as long as the patient is compliant. Its not difficult getting compliance by telling patient that it might be cancer, we cant be sure. That usually is enough to make the woman hysterical and submit to biopsy. The radiologist is happy because he thinks he is reducing his chances of being sued for malpractice. His partners and the hospital administrators are happy because the procedures bring in more income. If cancer is found, the surgeons are happy because they have more lumpectomies and cancer operations to keep them busy.

DCIS, the Controversial Non-Aggressive Cancer

Over half of the cancers detected with mammography are DCIS (ductal carcinoma in situ). This is a non-aggressive form of cancer which has a 98% survival after 5 years even with no treatment, although when found, they are treated with surgery as any other cancer. Some consider this detection and treatment of DCIS a form of overtreatment, others consider it good medical care.

Example small calcifications representing DCIS on an old Xerox-mammogram..

Some critics have said that increased mammographic detection of DCIS has skewed the statistics, falsely reducing breast cancer mortality. This makes it look like we are reducing breast cancer mortality, and we are not.

Without mammography, most of these DCIS cases would go undetected, and probably never cause a problem. Autopsy studies of women dying from car accidents have shown occult DCIS in up to 15% of the population. The actual incidence of cancer mortality is 0.4 per cent, not 15 per cent, suggesting that 96% of DCIS cases never go on to clinical disease. Yet, when DCIS is detected on the mammogram, these cases are treated with the same mastectomy or lumpectomy.

A third of the time, pathologists will disagree on the diagnosis of DCIS while looking at the same case. (11) (12)

Lung Cancer Screening

Screening tests in radiology have been tried before. For example chest x-ray screening for lung cancer was tried, studied and abandoned. It was found that when you do a chest X-ray on smokers every 6 months, find the cancers and send the patient to surgery for treatment, there is no change in mortality figures. No lives are saved. In addition to make matters worse, when you go back to the earlier films 6 months before, on the film that was read as negative or normal in retrospect the lesion is visible 90% of the time. (13) (14)

We thought these problems would be solved by moving up to CAT scans, a more advanced imaging technique. However, now we have a problem with seeing too many "suspicious" lesions and the false positive diagnosis. The net result is that lung cancer screening even with CAT scanning has not caught on. (15)

Mammogram screening in the under 50 age group NOT recommended by all other countries.

Current guidelines recommend a screening mammogram every 2 years for the 40-50 year age group. No other western country does this, as these women have dense breast tissue difficult to image and are most prone to a false positive reading, or a diagnosis of DCIS, the controversial less aggressive form of cancer. Most European countries restrict screening to post-menopausal women, after 50, when breast tissue involutes to fat and the cancers become more conspicuous.

Efficacy of Breast Cancer Screening - Does It Reduce Mortality?

The public perception is that breast cancer screening reduces breast cancer mortality. The reality is that this is a fiercely debated question in the medical literature with no clear winner. Leonard Berlin's articles summarize this debate in the medical literature. (3)

The debate is best shown by one example mentioned Dr. Berlin in the Sept 2002 issue of the Annals of Internal Medicine in which two conflicting articles appeared in the same issue, one stating that mammography has no mortality benefit, and the other saying it does.

Here are the two articles:

(1) Canadian researchers concluded that mammography screening did not reduce breast cancer mortality (16) (17)

(2) United States Preventive Services Task Force concluded mammography reduces breast cancer mortality among women 40-74 years old. (18) (19)

Another excellent review of major Mammography Screening Studies can be found at the National Breast Cancer Coalition (web site). (44)

Bottom line, the debate rages on with no clear winner.

One observation which might clarify the debate is this: in two countries with socialized medicine, Canada and Sweden, careful studies of mammography screening were found to have NO Mortality Benefit compared to breast clinical exam.

Here in the US, however, with a 4 billion dollar fee-for-service screening mammogram industry, the mammography studies are interpreted to show that Yes, there is a Mortality Benefit of about 15-20% .

The influence of money and politics over medical science is pervasive, and mammography is certainly not immune. A few MD PHD's from Canada or Sweden are not about to derail a 4 billion dollar industry in the US.

Conflict of Interest in Sponsoring Breast Cancer Awareness Month?

Screening mammography critic, Samuel Epstein MD, irritates the establishment every time he points out that in 1984, the American Cancer Society created the October National Breast Cancer Awareness Month sponsored by money from the Astra-Zeneca Company, the maker of Tamoxiphen, the best selling breast cancer drug. In addition, Astra-Zeneca also manufactures industrial chemicals that cause breast cancer. Some consider this a conflict of interest.

Epstein also points out that past ACS advertisement promised early detection results in a cure nearly 100% of the time. Even more seriously, the Awareness Month advertisements avoid any reference to information on avoidable causes and prevention of breast cancer. (20) (21)

What is breast cancer prevention?

A previous newsletter discusses Iodine supplementation as the most effective way to prevent breast cancer. Iodine tablets are safe, inexpensive and readily available. This is true prevention.(7)

Samuel Epsteins landmark book, "The Politics of Cancer" discusses carcinogenic chemicals in our food supply, home and workplace. Removing them can reduce breast cancer. This is true prevention. (22) (23)

The Untold Message of Breast Cancer Awareness Month:

To summarize, here is the untold message of Breast Cancer Awareness Month:

1) mammography screening is detection, not prevention and has several limitations, namely 30-70% missed cancers, and a tendency towards over diagnosis and over treatment. (5)

2) Many different carcinogenic chemicals cause breast cancer, and removing these chemicals from the workplace or home can reduce breast cancer rates. (22) (23)

3) Iodine deficiency causes fibrocystic disease, and Iodine supplementation prevents breast cancer.(7)

4) Synthetic hormones like Provera increase breast cancer risk. (WHI Study)(24)

5) Bio-Identical Hormone programs are safe, and do not increase risk of breast cancer. (French Cohort Study) (25)

Will mainstream medicine ever endorse Dr. Leonard Berlin's Truth-in-Mammography disclaimers ? No, this will never happen. The public's unrealistic expectation that a breast cancer nodule will be detected 100% of the time will continue, and the high cost of medical malpractice will simply be absorbed into "the cost of doing business". The screening mammogram is here to stay.

As for my own opinion, I am not opposed to the status quo of mammogram screening in the over 50 age group. However, I am opposed to creating unrealistic expectations with false and misleading advertising.

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Jeffrey Dach MD
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References

(1) American Cancer Society Breast Cancer Prevention Page: Yearly mammograms are recommended starting at age 40 and continuing for as long as a woman is in good health.

(1A) 3-29-2005 Leonard Berlin, M.D, FACR, Chairman of Radiology at Rush North Shore Medical Center, Skokie, will be awarded the Distinguished Service Gold Medal Award of the Chicago Radiological Society, its highest honor at a ceremony on April 21, in Chicago, IL. The Gold Medal is awarded annually to an individual who has rendered unusual service to the science of radiology and will be presented to Dr. Berlin by his son, radiologist Jonathan W. Berlin, M.D. Berlin is Charman of Skokie Valley Hospital Department of Radiology.

(1B) Leonard Berlin, MD Mammography Screening Can Survive Malpractice . . . If Radiologists Take Center Stage and Assume the Role of Educator

(2) Berlin L. The missed breast cancer redux: time for educating the public about the limitations of mammography? AJR Am J Roentgenol 2001; 176:1131–1134.

(3) Malpractice Issues in Radiology, Breast Cancer, Mammography, and Malpractice Litigation: The Controversies Continue Leonard Berlin,Excellent discussion of controversy of screening mammography and impact on mortality figures.

(4) Perspective Dot Size, Lead Time, Fallibility, and Impact on Survival Continuing Controversies in Mammography Leonard Berlin MD

(5) STATEMENT of Leonard Berlin, M.D. To the U.S. Senate Committee on Health, Education Labor and Pensions Re: Mammography Quality Standards Act Reauthorization April 8, 2003. Leonard Berlin: Suffice it to say that research studies performed at some of the most prestigious medical institutions in the United States reveal that as many as 90% of lung cancers, and 70% of breast cancers, can at least partially be observed on previous studies read as normal.

(6) A Manifesto for Truth-in-Mammography Advertising by Leonard Berlin MD Imaging Economics, November 2004 From cigarettes to pharmaceuticals to financial services, all advertisements feature a disclaimer: Why not those for mammography? Of all medical malpractice lawsuits filed in the United States that allege a delay in the diagnosis of breast cancer, radiologists are the most frequently sued specialists. Of all medical malpractice lawsuits lodged against radiologists, the most frequent cause is the allegation of a missed breast cancer on mammography. Why has "missed breast cancer" risen to first place in the medical malpractice standings? I suggest that it is because we have oversold mammography. We have marketed mammography without informing the American public all that we know about not only the benefits, but more important the limitations and potential harms of mammography.

(7) Iodine Prevents Breast Cancer by Jeffrey Dach MD

(8) Screening mammogram studies Swedish Study by Dr. Laszlo Tabar (1977- 1984) Population-based randomized controlled study 31% reduction in breast cancer mortality in women 50 plus

(9) INTERACTIVE MAMMOGRAPHY ANALYSIS WEB TUTORIAL Images of benign calcifications, secretory disease, milk of calcium, etc.

(10) Tutorial 2 : CALCIFICATIONS ASSOCIATED WITH A HIGH PROBABILITY OF MALIGNANCY

(11) Ductal Carcinoma In Situ of the Breast Elisabeth L. Dupont, MD; Ni Ni K. Ku, MD; Christa McCann, BA; and Charles E. Cox, MD, FACS DCIS, 60% of DCIS cases are discovered solely by mammography Seven major autopsy studies of women not known to have had breast cancer have provided insight. Six studies found an incidence of 4% to 18%.7 The seventh and largest study showed a 0.2% incidence (1 in 519 cases).8 However, this study included a significant proportion of groups known to have a smaller than usual risk of breast cancer. Of the more than 1,000 cases comprising these seven studies, only one case of invasive cancer was detected. Further analysis with fixed criteria is needed. (DCIS) this type of cancer now accounts for nearly half of mammographically detected cases of cancer.

(12) Using Autopsy Series To Estimate the Disease "Reservoir" for Ductal Carcinoma in Situ of the Breast: How Much More Breast Cancer Can We Find? H. Gilbert Welch, MD, MPH, and William C. Black, MD Annals of Internal Medicine December 1997 Volume 127 Issue 11 Pages 1023

(13) DOES LUNG CANCER SCREENING SAVE LIVES?

(14) Lung cancer screening

(15) Corporate Medical Policy Lung Cancer Screening, CT Scanning or Chest Radiographs BC BS doesn’t cover Lung cancer screening with chest CAT or Xrays.

(16) Miller AB, To T, Baines CJ, Wall C. The Canadian national breast screening study. 1. Breast cancer mortality after 11 to 16 years of follow-up. Ann Intern Med 2002;137:305 312 After 11 to 16 years of follow-up, four or five annual screenings with mammography, breast physical examination, and breast self-examination had not reduced breast cancer mortality compared with usual community care after a single breast physical examination and instruction on breast self-examination. The study data show that true effects of 20% or greater are unlikely. Controversy will persist because other studies suggest that screening causes small reductions in breast cancer mortality.The Editors

(17) Journal of the National Cancer Institute, Vol. 92, No. 18, 1490-1499, September 20, 2000 Canadian National Breast Screening Study-2: 13-Year Results of a Randomized Trial in Women Aged 50–59 Years Anthony B. Miller, Teresa To, Cornelia J. Baines, Claus Wall, For the Canadian National Breast Screening Study-2 Results: Randomization achieved virtually equal distribution of demographic and breast cancer risk variables. At the first annual screen, 21% of the cancers found by mammography alone (in the mammography plus physical examination group) were 20 mm or more in size compared with 46% of those found by physical examination in the mammography plus physical examination group and 56% in the physical examination-only group. The corresponding percentages for screens were 10%, 42%, and 50%, respectively. Screening detected 267 invasive breast cancers in the mammography plus physical examination group compared with 148 in the physical examination-only group. By December 31, 1993, 622 invasive and 71 in situ breast carcinomas were ascertained in the mammography plus physical examination group, and 610 and 16 were ascertained in the physical examination-only group. At 13-year follow-up, with 107 and 105 deaths from breast cancer in the respective groups, the cumulative rate ratio was 1.02 (95% confidence interval = 0.78 ). Conclusion: In women aged 50 - 59 years, the addition of annual mammography screening to physical examination has no impact on breast cancer mortality.

(18) Humphrey LL, Helfand M, Chan BKS, Woolf SH. Breast cancer screening: a summary of the evidence for the U. S. Preventive Services Task Force. Ann Intern Med 2002;137:347 -360 The U.S. Preventive Services Task Force recommends screening mammography, with or without clinical breast examination, every 1 to 2 years for women aged 40 and older.

(19) United States Preventive Services Task Force concluded mammography reduces breast cancer mortality among women 40-74 years old.

(20) Dangers and Unreliability of Mammography: Breast Examination is a Safe, Effective, and Practical Alternative Samuel S. Epstein, Rosalie Bertell, and Barbara Seaman International Journal of Health Services, 31(3):605-615, 2001.

(21) Cancer, Inc - National Breast Cancer - Awareness Month Sierra, Sept, 1999 by Sharon Batt, Liza Gross THEY MAKE THE CHEMICALS, THEY RUN THE TREATMENT CENTERS, AND THEY'RE STILL LOOKING FOR "THE CURE"--NO WONDER THEY WON'T TELL YOU ABOUT BREAST CANCER PREVENTION Astra Zeneca Sam Epstein

(22) Cancer Prevention Coalition

(23) The Politics of Cancer, Revisited 1998 By Samuel S. Epstein, M.D. Foreword by Congressman David Obey,Introduction by Congressman John Conyers In this book, world-cancer expert Dr. Samuel Epstein indicts the National Cancer Institute and the American Cancer Society for responsibility in losing the cancer war-

(24) Postmenopausal Hormone Replacement Therapy Scientific Review Heidi D. Nelson, MD, MPH; Linda L. Humphrey, MD, MPH; Peggy Nygren, MA; Steven M. Teutsch, MD, MPH; Janet D. Allan, PhD, RN JAMA. 2002;288:872-881.

(25) French Cohort Study

(26) Leonard Berlin MD biography

(27) Breast Imaging: From 1965 to the Present Edward A. Sickles, MD, Radiology. 2000;215:1-16.) Examples of xeromammograms and film mammograms, speculated lesion, needle localization.

(28) Case 41: Ductal Carcinoma in Situ, Alanna T. Harris, MD The detection of ductal carcinoma in situ has increased markedly in recent years secondary to the widespread use of screening mammography, and it now accounts for 25 to 40% of mammographically detected breast cancers

(29) History of Breast Cancer WILLIAM L. DONEGAN

(30) History: Narratives Radiology in Illinois By Franklin Alcorn, M.D. Dr. Alcorn's history appeared in the program of the Chicago Radiological Society at the Centennial of Radiology in 1995.

(31) Miller AB, To T, Baines CJ, Wall C. The Canadian national breast screening study. 1. Breast cancer mortality after 11 to 16 years of follow-up. Ann Intern Med 2002;137:305-312 After 11 to 16 years of follow-up, four or five annual screenings with mammography, breast physical examination, and breast self-examination had not reduced breast cancer mortality compared with usual community care after a single breast physical examination and instruction on breast self-examination. The study data show that true effects of 20% or greater are unlikely. Controversy will persist because other studies suggest that screening causes small reductions in breast cancer mortality.The Editors

(32) Journal of the National Cancer Institute, Vol. 94, No. 20, 1546-1554, October 16, 2002

Detection of Ductal Carcinoma In Situ in Women Undergoing Screening Mammography Virginia L. Ernster

Results: A total of 3266 cases of breast cancer were identified, 591 DCIS and 2675 invasive breast cancer. The percentage of screen-detected breast cancers that were DCIS decreased with age (from 28.2% [95% confidence interval (CI) = 23.9% to 32.5%] for women aged 40 to 49 years to 16.0% [95% CI = 13.3% to 18.7%] for women aged 70 to 84 years). However, the rate of screen-detected DCIS cases per 1000 mammograms increased with age (from 0.56 [95% CI = 0.41 to 0.70] for women aged 40 to 49 years to 1.07 [95% CI = 0.87 to 1.27] for women aged 70 to 84 years). Sensitivity of screening mammography in all age groups combined was higher for detecting DCIS (86.0% [95% CI = 83.2% to 88.8%]) than it was for detecting invasive breast cancer (75.1% [95% CI = 73.5% to 76.8%]).

Conclusions: Overall, approximately 1 in every 1300 screening mammography examinations leads to a diagnosis of DCIS. Given uncertainty about the natural history of DCIS, the clinical significance of screen-detected DCIS needs further investigation.

(33) Ductal Carcinoma In Situ of the Breast Elisabeth L. Dupont, MD; Ni Ni K. Ku, MD; Christa McCann, BA; and Charles E. Cox, MD, FACS

DCIS, 60% of DCIS cases are discovered solely by mammography Seven major autopsy studies of women not known to have had breast cancer have provided insight. Six studies found an incidence of 4% to 18%.7 The seventh and largest study showed a 0.2% incidence (1 in 519 cases).

However, this study included a significant proportion of groups known to have a smaller than usual risk of breast cancer. Of the more than 1,000 cases comprising these seven studies, only one case of invasive cancer was detected. Further analysis with fixed criteria is needed. (DCIS) this type of cancer now accounts for nearly half of mammographically detected cases of cancer.

(34) STATEMENT of Leonard Berlin, M.D. To the U.S. Senate Committee on Health, Education Labor and Pensions Re: Mammography Quality Standards Act Reauthorization April 8, 2003.

Leonard Berlin: Suffice it to say that research studies performed at some of the most prestigious medical institutions in the United States reveal that as many as 90% of lung cancers, and 70% of breast cancers, can at least partially be observed on previous studies read as normal.

(35) A Manifesto for Truth-in-Mammography Advertising by Leonard Berlin MD Imaging Economics, November 2004

From cigarettes to pharmaceuticals to financial services, all advertisements feature a disclaimer: Why not those for mammography?

Of all medical malpractice lawsuits filed in the United States that allege a delay in the diagnosis of breast cancer, radiologists are the most frequently sued specialists. Of all medical malpractice lawsuits lodged against radiologists, the most frequent cause is the allegation of a missed breast cancer on mammography. Why has "missed breast cancer" risen to first place in the medical malpractice standings? I suggest that it is because we have oversold mammography. We have marketed mammography without informing the American public all that we know about not only the benefits, but more important the limitations and potential harms of mammography.

(36) Mammography Books

(37) AJR 2001; 176:1123-1130

Perspective Dot Size, Lead Time, Fallibility, and Impact on Survival Continuing Controversies in Mammography Leonard Berlin

mammography had become the most prevalent procedure involved in malpractice lawsuits filed against radiologists, and that the allegation of an error in the diagnosis of breast cancer had become the most prevalent condition precipitating medical malpractice lawsuits against all physicians.

An article published in the ACR (American College of Radiology) Bulletin pointed out that 30-70% of breast cancers detected at followup mammography are visible in retrospect on initial mammograms that had been interpreted as showing normal findings

The debate as to whether screening mammography saves lives and lengthens survival rages on and will certainly not be resolved in the foreseeable future .

This article is not intended to be a comprehensive review of all available data on the subject of mammographic efficacy. Even if it were, no definitive answer to the question of whether mammography does indeed reduce mortality from breast cancer would be found.

(38) Journal of the National Cancer Institute, Vol. 92, No. 18, 1490-1499, September 20, 2000 Canadian National Breast Screening Study-2: 13-Year Results of a Randomized Trial in Women Aged 50 to 59 Years Anthony B. Miller, Teresa To, Cornelia J. Baines, Claus Wall, For the Canadian National Breast Screening Study-2

Results: Randomization achieved virtually equal distribution of demographic and breast cancer risk variables. At the first annual screen, 21% of the cancers found by mammography alone (in the mammography plus physical examination group) were 20 mm or more in size compared with 46% of those found by physical examination in the mammography plus physical examination group and 56% in the physical examination-only group. The corresponding percentages for screens were 10%, 42%, and 50%, respectively.

Screening detected 267 invasive breast cancers in the mammography plus physical examination group compared with 148 in the physical examination-only group. By December 31, 1993, 622 invasive and 71 in situ breast carcinomas were ascertained in the mammography plus physical examination group, and 610 and 16 were ascertained in the physical examination-only group. At 13-year follow-up, with 107 and 105 deaths from breast cancer in the respective groups

Conclusion: In women aged 50 to 59 years, the addition of annual mammography screening to physical examination has no impact on breast cancer mortality.

(39) Pink Ribbon Madness: Say No to Breast Cancer Exploitation for Corporate Profit

(40) article critical of mammographhy

(41) Dangers and Unreliability of Mammography: Breast Examination is a Safe, Effective, and Practical Alternative Samuel S. Epstein, Rosalie Bertell, and Barbara Seaman International Journal of Health Services, 31(3):605-615, 2001.

(42) AJR 2001; 176:1131-1134 Malpractice Issues in Radiology The Missed Breast Cancer Redux Time for Educating the Public About the Limitations of Mammography? Leonard Berlin

(43) Cancer, Inc - National Breast Cancer - Awareness Month Sierra, Sept, 1999 by Sharon Batt, Liza Gross

THEY MAKE THE CHEMICALS, THEY RUN THE TREATMENT CENTERS, AND THEY'RE STILL LOOKING FOR "THE CURE"--NO WONDER THEY WON'T TELL YOU ABOUT BREAST CANCER PREVENTION Astra Zeneca Sam Epstein

(44) National Breast cancer Coalition, Position Statement on Screening Mammography Updated May 2007

Excellent review of all studies up to May 2007. Overall, mammography screening has a modest effect on breast cancer mortality. When analyzed in absolute terms, the death rate is reduced by just 0.05%.

(45) Dr. Nortin Hadler is professor of medicine and microbiology/immunology at the University of North Carolina at Chapel Hill, and an attending rheumatologist at University of North Carolina Hospitals.

Does Screening Mammography Save Lives? Numbers May Not Justify Practice for Routine Mammograms

OPINION By NORTIN HADLER. M.D. In the United States, radiologists are so hesitant to read a mammogram as "normal" that false positive rates can reach 80 percent. This hedging on the readings is driven by the fact that "missing a breast cancer" on mammography is the most frequent reason for malpractice litigation in the United States.

But screening mammography is so terribly blunt that it approaches useless: It finds very few cancers that are truly treatable, it misses many of these and it is awash in false positives. Norway, Sweden, Australia and the United Kingdom are re-examining their national experience with screening mammography because of appraisals similar to mine.

If a woman's life was saved because of early detection of an evil breast cancer, she should thank her lucky stars rather than her mammographer. I would relegate mammograms to the archives of false starts, next to radical mastectomy

(46) After 40 Years, Mammography Remains as Much Emotion as Science Judith Randal

Journal of the National Cancer Institute, Vol. 92, No. 20, 1630-1632, October 18, 2000

For the better part of a century, it would have been unthinkable to treat primary breast cancer with anything but the operation pioneered in the 1890s by William Halsted, M.D., one of the most prominent surgeons of his day. Beginning in the 1970s, the Halsted era drew gradually to a close when randomized controlled trials found that the operation generally known as radical mastectomy was no more effective than less drastic surgery (sometimes in combination with radiation). Could a similar fate await the current gold-standard status of screening mammography? Will a time come when its popularity dwindles, too?

mammography now a $4 billion a year industry in the United States alone

Absent unforeseen developments, it is probably safe to predict that mammography for screening will continue to be as much about strongly held opinions and political pressures as about science.

(47) Good News and Bad News About Breast Cancer by David Plotkin M.D. The Atlantic Monthly

Breast cancer is a major public-health concern; it kills 0.04 percent of all American women yearly.

Most of the time the news is reassuring; two thirds to four fifths of all biopsies reveal that the abnormality is not malignant. (Women in their forties are more likely than older women to have negative biopsies, because mammograms of their naturally lumpier breasts are harder to interpret.)

An official nationwide mammography program would be a huge commitment: 51.5 million American women are aged forty or above. And one must bear in mind the cost of needless medical procedures generated by the huge number of false-positive mammograms—two to four false positives for every true positive, according to some measures.

On balance, then, I reluctantly support the status quo. When my patients come in for their mammograms, I do not try to dissuade them. But I tell them that the most optimistic interpretation of the available evidence suggests that routine mammography has only a marginal effect on a woman's chances of surviving breast cancer—and that it may have no effect at all.

(48) Journal of Clinical Oncology, Vol 21, Issue 1 (January), 2003: 41-45

High Prevalence of Premalignant Lesions in Prophylactically Removed Breasts From Women at Hereditary Risk for Breast Cancer

N. Hoogerbrugge, P. Bult, L.M. de Widt-Levert, L.V. Beex, L.A. Kiemeney, M.J.L. Ligtenberg, L.F. Massuger, C. Boetes, P. Manders, H.G. Brunner Full text

The fact that an occult carcinoma was present in only one of 67 patients in our study might indicate that surveillance is as effective as prophylactic mastectomy. However, in our study, all 10 DCIS cases were missed by surveillance, and it was recently shown by Meijers-Heijboer that surveillance is less effective than prophylactic mastectomy in preventing breast cancer deaths.

(49) Mammographic Screening for Breast Cancer Suzanne W. Fletcher, M.D., and Joann G. Elmore, M.D., M.P.H. NEJM Volume 348:1672-1680 April 24, 2003 Number 17

(50) POINT COUNTERPOINT On the efficacy of screening for breast cancer David A Freedman,1 Diana B Petitti,2 and James M Robins International Journal of Epidemiology 2004;33:4355

(51) International Journal of Epidemiology 2004;33:6973 Rejoinder David A Freedman, Diana B Petitti and James M Robins REJOINDER

(52) Screening for Breast Cancer. Joann G. Elmore, MD, MPH; Katrina Armstrong, MD; Constance D. Lehman, MD, PhD; Suzanne W. Fletcher, MD, MSc JAMA. 2005;293:1245-1256.

All major US medical organizations recommend screening mammography for women aged 40 years and older. Screening mammography reduces breast cancer mortality by about 20% to 35% in women aged 50 to 69 years and slightly less in women aged 40 to 49 years at 14 years of follow-up.

Approximately 95% of women with abnormalities on screening mammograms do not have breast cancer with variability based on such factors as age of the woman and assessment category assigned by the radiologist. Studies comparing full-field digital mammography to screen film have not shown statistically significant differences in cancer detection while the impact on recall rates (percentage of screening mammograms considered to have positive results) was unclear.

(53) Cancer Epidemiology Biomarkers & Prevention Vol. 13, 501-510, April 2004

Fear, Anxiety, Worry, and Breast Cancer Screening Behavior: A Critical Review Nathan S. Consedine, Carol Magai, Yulia S. Krivoshekova, Lynn Ryzewicz and Alfred . Neugut3

Women's fears surrounding breast cancer seem to encompass nearly "everything" but certainly include fear of a breast cancer diagnosis, fear of pain/discomfort, and more complicating, fear of embarrassment. To this list, we can add fear of the medical establishment, radiation, nonspecific "cancer worry" general anxiety, or phobia .

(54) Cancer: When it isn’t a killer DCIS: Precancer, benign cancer or what? What Doctors Don't Tell You (Volume 13, Issue 10)

The cancer establishment was recently rocked to its core when Professor Michael Baum, an eminent and well-respected breast surgeon and researcher, claimed that screening for breast cancer should be scrapped because it caused hundreds of healthy women to undergo risky, mutilating and unnecessary treatments even when they may never develop the disease. His comments, made at a meeting of the Royal Society of Medicine, cut even more deeply because Baum was one of the physicians who helped set up the 50-million-a-year breast-screening service (Frith M, Scrap Breast Cancer Screening, Evening Standard, 10 December 2002, p 1).

Baum has stated publicly that the most dramatic consequence of the rise in the numbers of routine mammographies has been a huge increase in the incidence of small, well-contained, relatively benign breast cancers known as ductal carcinoma in situ (DCIS) (BMJ Rapid Responses at bmj.com/cgi/eletters/325/ 7361/418#24945, 24 August 2002).

(55) Michael Baum, Emeritus Prof. of Surgery University College London The Portland Hospital, 212-214 Great Portland Street, London W1W 5QN Re: Screening and Mastectomy rates

(56) 'Scrap breast cancer screening' By Maxine Frith, Health Correspondent, Evening Standard 10.12.02

The man who helped to set up the NHS breast screening programme claims today that it does more harm than good.

Professor Michael Baum, a leading expert in the field, said that screening for the disease causes hundreds of healthy women to have risky, mutilating and unnecessary treatments even when they may never develop the disease.

Fifteen years after he established one of the first screening centres in the UK, Professor Baum has now called for the £50million a year service to be shut. He believes the techniques used for screening are not accurate enough and lead to too many false alarms.

Professor Baum, who is to address the Royal Society of Medicine in London today, has been a long-standing critic of screening but has never before gone so far as to say it should be scrapped entirely,

He is one of the most eminent breast surgeons in the country and a respected researcher into the disease. His comments have sparked a furious row among experts over the benefits of the NHS breast screening programme

(57) Breast screen 'wrong care' fears, Breast screening may produce false positives. Concerns have been raised that breast cancer screening might lead to some women undergoing unnecessary treatment. Researchers looked at international studies on half a million women. They found that for every 2,000 women screened over a decade, one will have her life prolonged, but 10 will have to undergo unnecessary treatment. UK experts said women over 50 should go for their breast checks, but a screening pioneer raised doubts about the NHS programme's future. The report, published in the Cochrane Library, involved a review of breast cancer research papers from around the world.

(58) Doubts raised by the pioneer of screening By Nic Fleming, Medical Correspondent 18/10/2006

(59) Screening for breast cancer with mammography. Gotzsche PC, Nielsen M Cochrane Reviews

Main results: Seven completed and eligible trials involving half a million women were identified. We excluded a biased trial from analysis.

Two (Canada and Malmo)trials with adequate randomisation did not show a significant reduction in breast cancer mortality, relative risk (RR) 0.93 (95% confidence interval 0.80 to 1.09) at 13 years; four trials with suboptimal randomisation showed a significant reduction in breast cancer mortality, RR 0.75 (0.67 to 0.83) (P = 0.02 for difference between the two estimates). RR for all six trials combined was 0.80 (0.73 to 0.88).

The two trials with adequate randomisation did not find an effect of screening on cancer mortality, including breast cancer, RR 1.02 (0.95 to 1.10) after 10 years, or on all-cause mortality, RR 1.00 (0.96 to 1.04) after 13 years. We found that breast cancer mortality was an unreliable outcome that was biased in favour of screening, mainly because of differential misclassification of cause of death.

Numbers of lumpectomies and mastectomies were significantly larger in the screened groups, RR 1.31 (1.22 to 1.42) for the two adequately randomised trials; the use of radiotherapy was similarly increased.

Authors' conclusions: Screening likely reduces breast cancer mortality. Based on all trials, the reduction is 20%, but as the effect is lower in the highest quality trials, a more reasonable estimate is a 15% relative risk reduction. Based on the risk level of women in these trials, the absolute risk reduction was 0.05%. Screening also leads to overdiagnosis and overtreatment, with an estimated 30% increase, or an absolute risk increase of 0.5%.

This means that for every 2000 women invited for screening throughout 10 years, one will have her life prolonged. In addition, 10 healthy women, who would not have been diagnosed if there had not been screening, will be diagnosed as breast cancer patients and will be treated unnecessarily. It is thus not clear whether screening does more good than harm. Women invited to screening should be fully informed of both benefits and harms.

(60) Should We Offer Routine Breast Cancer Screening with Mammography? SEAN P. DAVID, M.D., S.M., Brown Medical School, Pawtucket, Rhode Island July 15 2003

(61) Screening for breast cancer with mammography Gotzsche PC, Nielsen M cochrane collaboration 2006 full text pdf

(62) BMJ 2001;323:956 (27 October)

Row over breast cancer screening shows that scientists bring "some subjectivity into their work Susan Mayor, London

The review claimed that there was no reliable evidence to support the value of mammo-graphy screening in reducing deaths from breast cancer and alleged an association with increased rates of breast surgery.

Ole Olson and Peter Gotsche from the Nordic Cochrane Centre, Righospitalet, Copenhagen, Denmark, reassessed as part of a Cochrane review a meta-analysis of seven randomised trials of screening mammography which they had previously carried out. This confirmed their original conclusion, they said, that there was no evidence of a reduction in either total or breast cancer mortality in two of the trials that they considered to be of sufficient quality to analyse.

They added: "We have also confirmed that screening leads to more aggressive treatment, increasing the number of mastectomies by about 20% and the number of mastectomies and tumourectomies by about 30%" (Lancet 2001;358:1340-2 ).

(63) BMJ 2002;324:677 ( 16 March ) Hazel Thornton, independent advocate for quality in research and healthcare. Letters Breast screening seems driven by belief rather than evidence.

(64) BMJ 2001;323:1131 ( 10 November ) Letters. Office of NHS cancer screening programme misrepresents Nordic work in breast screening row Peter C Gotzsche, director. Nordic Cochrane Centre, Rigshospitalet, DK-2100 Copenhagen ø,

(65) List of articles in Lancet on Screening Mammography

(66) Professor of Radiology Course Director LÃzlo³ TabÃr, M.D. Professor of Radiology Course Director 2007 BREAST SEMINAR SERIES Covering the world of breast diagnosis

(67) Screening mammogram studies Swedish Study by Dr. Laszlo Tabar (1977- 1984) Population-based randomized controlled study 31% reduction in breast cancer mortality in women 50 plus

(68) National Breast Cancer Coalition (NBCC) The Mammography Screening Controversy:Questions and Answers February 8, 2002

(69) www.stopbreastcancer.org National Breast Cancer Coalition 1707 L Street, NW, Suite 1060 Washington, D.C. 20036 (202) 296-7477 voice (202) 265-6854 fax
Position Statement on Screening Mammography Updated May 2007

(70) BreastCancerChoices.org cancer advocacy Iodine Supplement Information
contact lynne. Breast Cancer Choices, Inc., a nonprofit organization
helping patients make informed choices about breast screening,
diagnostic procedures and treatment.

Womens perception of the benefits of mammography screening: population based survey in four countries. Domenighetti G, DAvanzo B, Egger M, et al.Int J Epidemiol 2003; 32:816 821.

Xeromammography is not quackery done by quacks says John Wolfe MD, author of Xeromamogram interpretation. Film screen mammography replaced it shortly there-after.

Enthusiasm for cancer screening in the United States. JAMA 2004; 291: 7178. Schwartz LM, Woloshin S, Fowler FJ Jr, Welch HG

Bartow SA, Pathak DR, Black WC, et al. Prevalence of benign atypical, and malignant breast lesions in populations at different risk for breast cancer: a forensic autopsy study. Cancer. 1987;60:2751-2760.

Ringberg A, Palmer B, Linell F, et al: Bilateral and multifocal breast carcinoma: A clinical and autopsy study with special emphasis on carcinoma-in-situ. Eur J Surg Cancer 17:2029, 1991

Do Vaccinations Cause Autism? by Jeffrey Dach MD

If you ask this question to anyone in the medical establishment, government or drug industry, the answer would be a firm NO, with supportive peer review medical publications. However, if you asked this question to mothers of autistic children, or the (DAN) physicians treating them, the answer would be a an equally emphastic YES, of course , pointing to their own supportive medical studies. (1)(2)(3)(3A)(4)(5) (93-99)

Canary in the Coal Mine

Autistic kids are the canaries in the coal mine, having genetic variations called SNP's (Single Nucleotide Polymorphisms), so they can't easily eliminate environmental toxins from their bodies. The most toxic is the ethyl mercury preservative in vaccines, unwittingly injected into young children before they are old enough to eliminate the mercury. Mercury impairs the immune system, causes auto-immune diseases, and is directly toxic to the brain, causing neurological disorders. (6)(7)(8)(9)

It's a Crime in Iowa and California

Iowa was the first state to ban mercury containing vaccines, Jan 2005. (106)

California has followed suit and more than 30 other states have similar bans under consideration.

In California, Governor Arnold Schwarzenegger signed the Thimerosal (Mercury) Law which took effect on July 1, 2006 prohibiting vaccination with mercury-containing vaccines to pregnant women or to children under age three. At the federal level, however, Pres. George Bush plans to veto similar legislation (FY 2008 HHS-Labor-Education Appropriations Bill). (10) (11)

The Most Bitter Debate

There is no greater rancor in medicine than the autism-vaccine debate, and this debate has reached the federal vaccine court where 5000 autistic kids and their families are requesting compensation for vaccine injury.

Vaccination Deemed Necessary to Protect Society

Society has deemed vaccination necessary to protect the nation from diseases such as smallpox, polio, diphtheria, and tetanus. In return for these benefits, society accepts the inevitable injury or death of the unlucky few from adverse effects. After all, vaccines contain foreign substances which provoke an immune response.

Examples of vaccine injury include the 1 death per million from viral encephalitis and disseminated viral infection after smallpox vaccination. Another example of vaccine injury is paralytic polio after receiving the live Sabin oral polo vaccine. With the eradication of polio, there are now more polio cases caused by the vaccine then are prevented by it in the US. (12)(13)(14)

The Swine Flu vaccine caused more deaths than did the Swine Flu itself, and there were 500 cases of vaccine associated Guillan Barre paralysis. Both the live polio vaccine and the Swine Flu vaccines have been discontinued in the US for these reasons. (15) (16)

The National Childhood Vaccine Injure Act

Large jury awards arising from DPT vaccine injury litigation in the 1980’s induced some vaccine makers to cease production, representing a threat to national military readiness in the case of biological warfare. (17)(18)

So, Congress passed the 1986 National Childhood Vaccine Injury Act to provide for uninterrupted vaccine production. This law made the vaccine manufacturers immune from civil litgation, and instead established a Federal Court system to provide speedy compensation for vaccine-related injuries or death. (19)

The court uses a table which lists the types of injuries which automatically qualify for compensation. However, Autism is not included in this table. (20)

5000 Autism Cases Before the Vaccine Court

There are currently 5,000 cases before the Federal Vaccine Court requesting compensation for vaccine related autism, and a ruling is expected within the next 6-12 months.(21)(22)(108)

The 5,000 autistic families are represented by Kevin P. Conway, Ronald C Homer & Syvia Chin-Caplan, 16 Shawmut Street, Boston, MA 02116, Phone: 617-695-1990 (23)(24)

Acceptance by the Medical Establishment Not Necessary

A previous case was a victory. In Capizzano 05-5049 (3/9/2006),the Court decided that peer-reviewed scientific literature was not needed to win compensation. All that was needed was a medical theory linking an injury to the vaccine, a logical sequence of cause and effect, and a temporal relationship between them. This can be accomplished by medical records, or by an expert opinion. Peer-reviewed literature, pathological markers, rechallenge and general medical acceptance, are not required to win compensation.

In other words, it is not necessary for the acceptance by the medical establishment that vaccines cause autism., nor was it necessary for the peer review literature to show that vaccines cause autism. All that is needed is to show that Johnny was OK before the vaccination, and after the vaccination, Johnny developed autism.

280 Billion Dollars for Autistic Children - Do the Math

The current rate of autism as 1 in 150 children. Since there are 4 million live births annually in the US, this calculates out to 28,000 autistic kids annually, or 280,000 autistic kids per decade. Assuming the 5000 autistic families prevail in court with an average payout of one million dollars per autistic child, with the potential for 280,000 claims, the potential payout could amount to 280 billion dollars. This is an incredibly large amount of money, about the same amount of spending for 2 years of war in Iraq.(25) For this reason alone, it seems inconceivable that the federal vaccine court would grant compensation for autism. However, only time will tell.

Vaccine-Strain Measles Detected in Autistic Kids from MMR

The Vaccine Court’s compensation table includes Vaccine-strain measles infection, so these autistic kids would automatically be entitled to compensation. There are a number of reports of measles infection in the small bowel in autistic kids shown with endoscopic biopsy and PCR testing. Of course, mainstream medicine claims these findings are debatable, as seen in this article in Nature by DeStefano. (26)(27)(28)(70-75).

Lack of Evidence of Harm

As expected, the medical establishment claims there is a lack of evidence that thimerosol vaccines cause autism, and lack of evidence that the MMR vaccine causes persistent measles infection. (29)(30)(31)(32)(33)(34)(35)(36)

A recent Sept 2007 New England Journal of Medicine (NEJM) article speaks against the notion that thimerisol containing vaccines cause neurological problems.(37)

Autism is Increasing to Epidemic Proportions

A decade ago, the rate of autism was 1 per 10,000. The CDC now says that the current autism rate is 1 per 150. Some say that this dramatic rise in autism rates correlates with the increase in mercury exposure with Thimerosal, as children vaccination schedules have increased. See diagram below. (38)

Mothers Report the Children Are Fine until the Vaccinations, and then Develop Autism

Thousands of families are reporting their normal children changed after receiving mercury-containing vaccines, and began displaying Autism symptoms (which mimic mercury poisoning). (100).

Children with autism have more measurable mercury in their bodies than normal children, because they have difficulty eliminating it. A typical mercury dose received by a two-month old after three mercury vaccines is 125 times EPA's daily allowable exposure levels. In 2001, the Institute of Medicine (IOM) stated it is "biologically plausible" that Thimerosal in vaccines caused autism, ADD/ ADHD and neurodevelopment disorders in general. (40) (41) (42) (43) (44)(45)(46)(47)(48)

Videos on You Tube

There are many videos posted on U-Tube showing a typical story. The new born child develops normally, is then vaccinated and becomes autistic. After biologic treatment by a DAN physician the child dramatically improves. (Click Here for Video) (39)

What are the Features of autism?

The autistic child becomes non-verbal, with no self expression, and assumes postures to put pressure on lower abdomen (indicating pain). There may be hand flapping, and stacking objects. The autistic child shows no interest in other people, or he may be interested in people, but does not know how to talk with, play with, or relate to them. Initiating and maintaining a conversation is difficult. Speech and language skills may begin and then be lost, or they may develop very slowly, or they may never develop. The autistic child may have repeated ritualistic actions such as spinning, rocking, staring, finger flapping, and hitting self. Autistic kids have neurological disorders including epilepsy, gastro-intestinal problems, fine and gross motor deficits, and anxiety and depression. Boys are nearly 4 times more likely to have a parent-reported autism diagnosis than girls. There are about (80 Videos) on You Tube which show the typical signs of Autism: (49)

See Dr. Arthur Krigsman’s (video presentation) on Autism (DAN 2004 meeting) (50)(52)(53).

Symptoms and Biologic Treatment of Autism - Dr. Arthur Krigsman

50-70 % of autistic kids get a gasterointestinal disorder called autism associated entero-colitis, with inflammation of small bowel, stomach, and esophagus. They may have abdominal pain, diarrhea (loose stool, unformed stool, chronic oatmeal consistency, undigested food, malabsorption, constipation, malodorous stools. They may have abdominal distention, due to bowel inflammation and excessive gas. Growth curve may show regression at the onset of GI symptoms and onset of cognitive regression at the 15 month time frame.

Endoscopy finds pathology in these 70% who may have constipation/diarrhea with difficulty passing stool, or 3-4 days without a bowel movement. Endoscopy of small bowel shows lymphoid nodular hyperplasia, and severe LNH resembles Crohns disease.

Leaky Gut Syndrome in Autistic Kids

Autistic kids have an inflamed gut membrane which has increased intestinal permeability, also called “leaky gut” syndrome. In leaky gut, the undigested food macromolecules are absorbed by the leaky gut into the blood stream, an abnormal event. Metabolic pathways to break down these macromolecules are not normally in use.

Gluten from bread, and Casein from milk derivatives produce opioids, which are found in urine of autistic children. By removing the offending foods, the opioids disappear. There are 28 other proteins present in urine whih can b detcted with organic acid testing at the Great Plains Lab, William Shaw. (54)(55)(56)

Gut inflammation can be controlled on long term basis with anti-inflammatory drugs for biopsy proven inflammation on endoscopy. These are 5ASA drugs like Sulfadiazine, and the Salicylates. Very few patients cannot tolerate these drugs. Some kids need steroids (2-4 weeks), same as Crohn’s disease cases. Anti-Fungals (nystatin, diflucan) are widely used by DAN practitioners. Parents will say the kids do better on anti-fungals even though it is difficult to demonstrate fungus found on culture. Organic acid urine tests typically show presence of fungal metabolites which disappear with anti-fungal drugs. Autistic kids are also given digestive enzymes and probiotics which help to improve GI and cognitive symptoms.

Mothers Claim their Autistic Childs with Chelation therapy which removes Mercury

Katie Wright revealed that her autistic son Christian (grandson of NBC Chair Bob Wright), recovered significant function after chelation treatments to remove mercury. (101)(102).

As customary, she was viciously attacked by the medical establishment for her public statement. However, Katie was vigorously defended by John F Kennedy Jr. in this Huffington Post article.(57)(58)(59)(105)(107)

How To Make Vaccinations Safer

To make vaccination safer, Stephanie Cave MD and Sherry Tenpenny have suggested waiting until child is older to give the vaccinations, use single dose mercury-free vaccines, and use vitamin supplements such as Vitamin A and C prior to vaccination. They suggest avoiding vaccination when the child is sick. (60) (61)

Dr. Cave recommends waiting to vaccinate until ther child is at least 6 months of age, preferably older. Do only one vaccine at a time, at least a month apart.

Vaccination is NOT mandatory. Use an Exemption

Information on exemptions was mentioned in a previous newsletter. (62)

New Medical Discoveries Are Usually Rejected

Ignatz Semmelweis, for example, was ridiculed for his suggestion that surgeons should wash their hands before an operation.(63) The British Navy finally gave limes to sailors 50 years after James Lind’s showed citrus fruit cured scurvy.(64) As a reward for his discovery that elevated homocysteine causes heart disease, Kilmer McKully MD, was fired from his job and research grant terminated.(65 ) The thimerisol-autism connection is just another example of the above.

In Iowa and California, it is a illegal to inject a newborn with mercury with the newborn Hepatitis B shot, and and it should be crime in your state as well. Hepatitis B is obtained through IV drug abuse, or via sexual transmission, both activies not possible for newborns.

Hopefully, the injection of mercury into newborns will soon become a relic of the past, taking its rightful place in the museum along with bloodletting and leeches. Until then, there is much work to be done to remove mercury from our vaccinations. As a nation, we can’t afford not to. (66)

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Regards,

Jeffrey Dach, M.D.
4700 Sheridan, Suite T.
Hollywood Florida, 33021
954 983 1443

www.drdach.com
www.jeffreydach.com
www.truemedmd.com

References can be found at th orihinal article at:

http://jeffreydach.com/2007/10/11/autism-vaccines-and-robert-f-kennedy-jr-by-jeffrey-dach-md.aspx

(1) Do Vaccines Cause Autism ?

(2) DEFEAT AUTISM NOW! (DAN!) Physician Referral List: Implementing the Defeat Autism Now!

(3) Biological Evidence of Significant Vaccine Related Side-effects Resulting in Neurodevelopmental Disorders. Presentation to the Vaccine Safety Committee of the Institute of Medicine, The National Academies of Science, February 9, 2004.Jeff Bradstreet MD, ICDRC, 321-953-0278

(3A)Molecular Aspects of Thimerosal-induced Autism Richard C. Deth, Ph.D. Professor of Pharmacology Northeastern University Boston, Massachusetts

(4) Deth's research has uncovered evidence thimerosal creates deficits in the D4 receptor-mediated phospholipids methylation essential for detoxification and sustaining attention to tasks. The research provides the first scientific link between attention deficits and autism. Deth has identified the metabolic process, called methylation, whereby thimerosal can cause the brain damage associated with autism.

(5) An enzyme critical to methylation, methionine synthase, uses an active form of vitamin B12 to complete its chemical function, according to Deth. Thimerosal interferes with the conversion of dietary forms of B12 into the active form and so impedes DNA methylation and disrupts some normal gene actions.

(6) Mercury Poisoning

(7) EPA mercury Site

(8) HHS agency for Toxic Substances

(9) Mass Dept of Environmental Protection

(10) California Mercury Law

(11) Bush will VETO similar Mercury Law

(12) WHO Cessation of Oral (live) polio vaccine,Policy paper.

(13) Oral Polio Vaccine Cessation

(14) vaccinia smallpox CDC info

(15) Swine Flu Vaccination

(16) The Sky is Falling: An Analysis of the Swine Flu Affair of 1976, by Joel Warner

(17) The Tainted History of the DPT Vaccine by Harold Stearley

(18) At Risk: Truth About Vaccines, Lawsuits & Shortages Barbara Loe Fisher

(19) Office of Special Masters of the U.S. Court of Federal Claims,

(20) Vaccine Injury Table outlining which vaccine related injuries are to be compensated.

(21) Current status of 4900—claims for vaccine injuries resulting in autism spectrum disorder before US Court of Federal Claims, Special masters Patricia Campbell Smith, Denise Vowel and George L Hastings Jr. Ruling is expected after Jan 15, 2008.

(22) Audio and written transcripts of this first test case. the Cedillo Case No. 98-916V are available at this page:

(23) Homer legal web site. news and links relating to vaccine litigation.

(24) Federal Vaccine Court decisions with summary and full pdf file of transcripts.

(25) The Possible Costs to the United States of Maintaining a Long-Term Military Presence in Iraq September 2007

(26) references pertaining to measles MMR vaccine and autism. The vaccine strain of measles virus has been found in 85% of samples taken from the guts of children with regressive autism, according to Dr. Stephen Walker of the Wake Forest University School of Medicine.The study replicates findings made by Dr. Andrew Wakefield, a gastroenterologist, in 1998, and by Prof. John O’Leary, a pathologist, in 2002.

(27) Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Mol Pathol. 2002 April; 55(2): 84–90. V Uhlmann, C M Martin, O Sheils, L Pilkington, I Silva, A Killalea, S B Murch, J Walker-Smith, M Thomson, A J Wakefield, and J J O'Leary.

Results: Seventy five of 91 patients with a histologically confirmed diagnosis of ileal lymphonodular hyperplasia and enterocolitis were positive for measles virus in their intestinal tissue compared with five of 70 control patients. Measles virus was identified within the follicular dendritic cells and some lymphocytes in foci of reactive follicular hyperplasia. The copy number of measles virus ranged from one to 300 000 copies/ng total RNA. onclusions: The data confirm an association between the presence of measles virus and gut pathology in children with developmental disorder.

(28) VACCINES AND AUTISM Detection of measles virus in children with ileo-colonic lymphoid nodular hyperplasia, enterocolitis and developmental disorder Molecular Psychiatry (2002) 7, S47–S48. Martin CM, Uhlmann V, Killalea A, Sheils O, O'Leary JJ.

(29) wikipedia MMR vaccine

(30) VACCINES AND AUTISM MMR vaccine and autism: a review of the evidence for a causal association Molecular Psychiatry (2002) 7, S51–S52. CDC finds NO causal association F DeStefano National Center on Birth Defects and Developmental Disabilities, CDC

(31) New Data refutes Measles Virus from Vaccine in Children with Autism,

(32) PEDIATRICS Vol. 118 No. 1 July 2006, pp. e139-e150 Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links With Immunizations Eric Fombonne, MDa, Rita Zakarian, MEda, Andrew Bennett, PhD, CPsychb, Linyan Meng, MSca and Diane McLean-Heywood, MAb The findings ruled out an association between pervasive developmental disorder and either high levels of ethylmercury exposure comparable with those experienced in the United States in the 1990s or 1- or 2-dose measles-mumps-rubella vaccinations.

(33) The "Wakefield" Studies: Studies Hypothesizing That MMR Causes Autism Dr. Paul Offit, M.D., FAAP, Chief of Infectious Diseases and Director of the Vaccine Education Center at Children's Hospital of Philadelphia. Those who claim that MMR causes autism often cite two papers by Andrew Wakefield and colleagues. This section summarizes those studies and lists their critical flaws.Conclusion; autism is not caused by thimerosol vaccines

(34) Web site which states that Autism not caused by vaccines, funded by CDC

(35) The relationship between the MMR vaccine and autism, From The Vaccine Education Center Newsletter AMA page denying link between thimerosol vaccines and autism

(36) VACCINE STUDY IN NEW ENGLAND JOURNAL OF MEDICINE WRONG IN CONCLUDING MERCURY EXPOSURES ARE HARMLESS, STATES SAFEMIN"Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years," appearing in the New England Journal of Medicine (NEJM, 9/27/07 issue), DS

(37) A Sept 2007 NEJM article speaks against the notion that thimerisol containing vaccines cause neurological problems. Volume 357:1281-1292 September 27, 2007 Number 13 Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years

(38) VOLUME 114 | NUMBER 7 | July 2006 • Environmental Health Perspectives diagram of autism epidemic rise

(39) Video BioMedMom,on YouTube showing Autistic Child Development

(40) Critical Issues, Mercury from Safe Minds.org

(41) Stephanie Cave Book, What Your Doctor May Not Tell You About Children's Vaccinations, by Stephanie Cave, M.D., F.A.A.F.P and Deborah Mitchell.

(42) Video: Dr. Mark Geier Speaks at Mercury-Free Vaccines Rally in front of CDC 2007

(43) Video You Tube: Dr. Mary Megson Speaks on Autism Epidemic and Vaccines in front of CDC 2007

(44) Video: Boyd Haley, PhD Speaks at Mercury-Free Vaccines Rally at CDC 2007

(45) Video: Shows How Mercury Kills the Brain ~ Autism Connection

(46) Sherri J. Tenpenny, D.O. Vaccinations, Alternative Medicine, Mothering MAgazine.

(47) A prospective study of mercury toxicity biomarkers in autistic spectrum disorders. Geier DA, Geier MR. J Toxicol Environ Health A. 2007 Oct;70(20):1723-30.

(48) Urinary porphyrin profile analysis (UPPA) to assess body-burden and physiological effects of mercury in children diagnosed with ASDs.

(49) Video on You Tube: Signs of Autism

(50) Video:Current Concepts in the Treatment of Autistic Spectrum Associated Enterocolitis, Arthur Krigsman, M.D.Presented at DAN conference 2004. next meeting appearance National Autism Association November 9-11, 2007, Atlanta

(52) Arthur Krigsman MD Web Site, pediatric gasteroenterologist, Bio

(53) Arthur Krigsman MD Gasteroenterologist Wikipedia

(54) Great Plains Lab web site

(55) Biological Treatment of Autism by William Shaw PhD

(56) The Official Autism 101 Manual is the most comprehensive book on Autism"

(57) Robert F. Kennedy Jr defends attack on Mothers, The poisonous public attacks on Katie Wright this week--for revealing that her autistic son Christian (grandson of NBC Chair Bob Wright), has recovered significant function after chelation treatments to remove mercury -- surprised many observers unfamiliar with the acrimonious debate over the mercury-based vaccine preservative Thimerosal. But the patronizing attacks on the mothers of autistic children who have organized to oppose this brain-killing poison is one of the most persistent tactics employed by those defending Thimerosal against the barrage of scientific evidence linking it to the epidemic of pediatric neurological disorders, including autism. Mothers of autistics are routinely dismissed as irrational, hysterical, or as a newspaper editor told me last week, "desperate to find the reason for their children's illnesses," and therefore, overwrought and disconnected.

(59) Video: Christian and Makena, Non verbal aggressive little guy has turned into a wonderful healthy little boy with the help of the specific carbohydrate diet, vitamins, supplements, chelation therapy, ABA, Occupational and Speech therapy.

(60) Interview with Stephanie Cave MD, Mothering MAgazine

(61) Dr. Sherry Tenpenny. In 1987, the World Health Organization advocated the combined administration of Vitamin A with the measles vaccine. When a dose of 100,000 IU of Vitamin A is given with the vaccine, lower rates of side effects occur, and antibodies still develop. Therefore, be sure to give your child is given Vitamin A on the day s/he receives the vaccine. I would also suggest giving powdered Vitamin C (10mg per pound), for 3 days before, the day of, and for 5 days after any vaccine. If you chose to vaccinate, I recommend that you wait until your child is at least 6 months of age, preferably older. Do only one vaccine at a time, at least a month apart

(62) Guard Your Daughters from Gardasil

(63) Ignaz Semmelweiss

(64) James Lind and the Story of Scurvy

(65 ) Kilmer McCully MD and the discovery of the Homocytseine cause for heart disease

(66) Blood Letting Antique Medical Museum

(67) Wakefield AJ and Montgomery SM. Autism, viral infection and measles mumps rubella vaccination. Israeli Medical Association Journal 1999;1:183-187

(68) A prospective study of mercury toxicity biomarkers in autistic spectrum disorders. Geier DA, Geier MR. J Toxicol Environ Health A. 2007 Oct;70(20):1723-30.

(69) Press Release September 30, 2007 WASHINGTON, DC – A new peer-reviewed scientific/medical case study confirms that many children with autistic spectrum disorders (ASDs) suffer from mercury poisoning. The new study, “A Prospective Study of Mercury Toxicity Biomarkers in Autistic Spectrum Disorders” by Mr. David A. Geier and Dr. Mark R. Geier has been published in the most recent issue of the Journal of Toxicology and Environmental Health, Part A (volume 70, issue 20, pgs 1723-1730).

(70) Uhlmann V., Martin C, Shiels, Wakefield AJ, O’Leary JJ. Possible viral pathogenesis of a novel paediatric inflammatory bowel disease. Molecular Pathology 2002;55:84-90

(71) Singh VK, Lin SX, Yang VC. Serological association of measles virus and human herpesvirus-6 with brain autoantibodies in autism. Clin Immunol Immunopathol. 1998;89:105-8.

(72) Singh VK, Jensen RL, Elevated levels of measles antibodies in children with autism, Pediatric Neurology, 2003;28:292-294.

(73) Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autism. Singh VK, Lin SX, Newell E, Nelson C.Department of Biology and Biotechnology Center, Utah State University, Logan, Utah 84322, USA. singhvk@cc.usu.edu, J Biomed Sci. 2002 Jul-Aug;9(4):359-64.

(74) Wakefield, A.J., et al.Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children Lancet 351: 637-641, 1998.

(75) Uhlmann, V., et al. Potential viral pathogenic mechanism for new variant inflammatory bowel disease. Journal of Clinical Pathology: Molecular Pathology 55:1-6, 2002.

(76) Taylor, B., et al. Autism and measles, mumps, and rubella vaccine: no epidemiological evidence for a causal association. Lancet 353:2026-2029,1999.

(77) VACCINES AND AUTISM IMMUNIZE, Paul A. Offit, MD, Director, Vaccine Education Center, Children’s Hospital of Philadelphia

(78) Dales, L., et al. Time trends in autism and in MMR immunization coverage in California. JAMA 285:1183-1185, 2001

(79) Lancet. 2000 Oct 7;356(9237):1273.Response to the MMR question.Taylor B, Miller E, Farrington CP.

(80) Kaye, J.A., et al. Mumps, measles, and rubella vaccine and the incidence of autism recorded by general practitioners: a time trend analysis. Brit Med J 322:460-463, 2001.

(81) Taylor, B., et al. Measles, mumps, and rubella vaccination and bowel problems or developmental regression in children with autism: population study. Brit Med J 324:393-396, 2002.

(82) Adrien, J., et al. Blind ratings of early symptoms of autism based upon family home movies. J Am Acad Child Adolesc Psychiatry 32:617-626, 1993.

(83) Adrien, J., et al. Early symptoms in autism from family home movies: evaluation and comparison between 1st and 2nd year of life using I.B.S.E. scale. Acta Paedopsychiatrica 55:71-75, 1992.

(84) Adrien, J., et al. Autism and family home movies: preliminary findings. J Autism Devel Disorders 21:43-49, 1991.

(85) Osterling, J., et al. Early recognition of children with autism: a study of first birthday home videotapes. J Autism Devel Disorders 24:247-257, 1994.

(86) Mars, A.E., et al. Symptoms of pervasive developmental disordeers as observed in prediagnostic home videos of infants and toddlers. J Pediatr 132:500-504, 1998.

(87) Proc Natl Acad Sci U S A. 1998 Nov 10;95(23):13982-7. Links Movement analysis in infancy may be useful for early diagnosis of autism.Teitelbaum P, Teitelbaum O, Nye J, Fryman J, Maurer RG.

(88) Jefferson T, Price D, Demicheli V, Bianco E. Unintended events following immunization with MMR: a systematic review. Vaccine 2003; 21: 3954-3960

(89) Demicheli V, Jefferson T, Rivetti A, Price D. Vaccines for measles, mumps and rubella in children (Review). The Cochrane Collaboration 2005

(90) Balzola F, Daniela C, Repici A, Barbon V, Sapino A, Barbera C, Calvo PL, Gandione M, Rigardetto R, Rizzetto M. Autistic enterocolitis: confirmation of a new inflammatory bowel disease in an Italian cohort of patients. Gastroenterology. 2005;128:Suppl.2;A-303

(91) Balzola F., Barbon V.,Repici A., Rizzetto M., Clauser D., Gandione M., Sapino A., Panenteric IBD-Like Disease in a Patient with Regressive Autism Shown for the First Time by the Wireless Capsule Enteroscopy: Another Piece in the Jigsaw of this Gut-Brain Syndrome? American Journal of Gastroenterology. 2005;100:979

(92) González L., López K., Martínez M., Navarro D., Negrón L., Rodríguez R., Villalobos D., Flores L., Sabrá A. Endoscopic and Histological Characteristics of the Digestive Mucosa in Autistic Children with Gastrointestinal Symptoms. Preliminary Report. G.E.N. Suplemento Especial de Pediatría-Nº 1, 2005; pp41-47.

(93) Autism articles and References

(94) Measles-Mumps-Rubella Vaccine and Autistic Spectrum Disorder: Report From the New Challenges in Childhood Immunizations Conference Convened in Oak Brook, Illinois, June 12-13, 2000 Neal A. Halsey, MD, Susan L. Hyman, MD, and the Conference Writing Panel Conclusions. Although the possible association with MMR vaccine has received much public and political attention and there are many who have derived their own conclusions based on personal experiences, the available evidence does not support the hypothesis that MMR vaccine causes autism or associated disorders or IBD. Separate administration of measles, mumps, and rubella vaccines to children provides no benefit over administration of the combination MMR vaccine and would result in delayed or missed immunizations. PEDIATRICS Vol. 107 No. 5 May 2001, p.e84

(95) Vaccine truth

(96) Regressive Autism, Ileal-Lymphoid Nodular Hyperplasia, Measles Virus and MMR Vaccine Summary of Published Studies Offering Evidence for Linkages By David Thrower

(97) Vaccine Autoimmune Project for Research and Education (VAP) VAP's co-founder Ray Gallup and Dr. Yazbak examine the most recent United States Department of Education statistics and reveal that the 1 in 150 estimate is outdated by five years. They report that the present prevalence of ASD may be as high as 1 in 67.

(98) Biological Evidence of Significant Vaccine Related Side-effects Resulting in Neurodevelopmental Disorders. Presentation to the Vaccine Safety Committee of the Institute of Medicine, The National Academies of Science, February 9, 2004. Jeff Bradstreet MD, ICDRC, 321-953-0278

(99) Gastrointestinal comorbidity, autistic regression and Measles-containing vaccines: positive re-challenge and biological gradient Andrew J. Wakefield, FRCS FRCPath; Carol Stott, PhD; and Kirsten Limb, BSc A.J. Wakefield, C. Stott, K. Limb / Medical Veritas 3 (2006) 796–802

(100) Mercury & Autism Comprehensive research into the autism mercury poisoning connection. Autism: A Unique Type of Mercury Poisoning. See Table A: Summary Comparison of Characteristics of Autism & Mercury Poisoning. Sallie Bernard, Albert Enayati, B.S.Teresa Binstock Heidi Roger Lyn Redwood, R.N., M.S.N., C.R.N.P. Woody McGinnis, M.D. Contact: (201) 444-7306 by ARC Research

(101) Katie Wright, Autism Debate Strains a Family and Its Charity New York Times

(102) Autism Every Day Film with Katie Wright at Sundance Film Festival

(103) Book Review :Louder Than Words By Jenny McCarthy on TACANOW

(104) Jenny Mccarthy Interview in People Magazine, author of Louder than Words, on New York Times Best Seller List. number 5 on 10/15/07

(105) Robert F Kennedy Jr. Home Web Site

(106) Iowa Health Fredom Coalition, First State to Ban Mercury in Vaccines.

(107) Deadly Immunity, originally published on Salon.com June 16, 2005
by Robert F Kennedy Jr

(108) Cases in Vaccine Court — Legal Battles over Vaccines and Autism Stephen D. Sugarman, J.D. NEJM, Volume 357:1275-1277 September 27, 2007 Number 13

Books:

Louder Than Words, By Jenny McCarthy, on the New York Times Best Seller List No. 5,
Non-Fiction HardCover 10/15/07.(103)

Vaccines, Autism and Childhood Disorders: Crucial Data That Could Save Your Child's Life (Paperback) by Neil Z. Miller (Author), Bernard Rimland (Foreword)

What Your Doctor May Not Tell You About Children's Vaccinations (Paperback) by Stephanie Cave MD(Author), Deborah Mitchell

A Shot in the Dark (Paperback) by H. Coulter (Author)

How to Raise a Healthy Child in Spite of Your Doctor (Mass Market Paperback) by Robert S. Mendelsohn MD

Evidence of Harm: Mercury in Vaccines and the Autism Epidemic: A Medical Controversy (Paperback) by David Kirby

Vaccines: Are They Really Safe and Effective (Paperback) by Neil Z. Miller

Vaccinations: A Thoughtful Parent's Guide: How to Make Safe, Sensible Decisions about the Risks, Benefits, and Alternatives (Paperback) by Aviva Jill Romm

Vaccine Guide: Risks and Benefits for Children and Adults (Paperback) by Randall Neustaedt

References for Autism

1
http://specialchildren.about.com/od/autismandvaccines/i/vaccines.htm
Do Vaccines Cause Autism

2 http://www.autismwebsite.com/practitioners/danus.html
DEFEAT AUTISM NOW! (DAN!) Physician Referral List: Implementing the Defeat Autism Now!

3 http://www.nationalautismassociation.org/pdf/IOM-Bradstreet.pdf

Biological Evidence of Significant Vaccine Related Side-effects Resulting in Neurodevelopmental Disorders. Presentation to the Vaccine Safety Committee of the Institute of Medicine,
The National Academies of Science, February 9, 2004.
Jeff Bradstreet MD, ICDRC, 321-953-0278

3A http://www.whale.to/a/deth.pdf
Molecular Aspects of Thimerosal-induced Autism
Richard C. Deth, Ph.D. Professor of Pharmacology Northeastern University Boston, Massachusetts

4 http://en.wikipedia.org/wiki/Richard_Deth
Deth's research has uncovered evidence thimerosal creates deficits in the D4 receptor-mediated phospholipids methylation essential for detoxification and sustaining attention to tasks. The research provides the first scientific link between attention deficits and autism. Deth has identified the metabolic process, called methylation, whereby thimerosal can cause the brain damage associated with autism.

5 http://www.sciencenews.org/articles/20041113/bob8.aspAn enzyme critical to methylation, methionine synthase, uses an active form of vitamin B12 to complete its chemical function, according to Deth. Thimerosal interferes with the conversion of dietary forms of B12 into the active form and so impedes DNA methylation and disrupts some normal gene actions.

6 http://en.wikipedia.org/wiki/Mercury_poisoning Mercury Poisoning

(7) http://www.epa.gov/mercury/ EPA mercury Site

(8) http://www.atsdr.cdc.gov/substances/mercury/index.html
HHS agency for Toxic Substances

(9) http://www.mass.gov/dep/toxics/stypes/hgres.htm
Mass Dept of Environmental Protection

(10) http://www.dhs.ca.gov/ps/dcdc/izgroup/shared/mercury_law.htm
California Mercury Law

(11)http://www.autismtoday.com/articles/Bush%20To%20Veto%20Ban%20On%20Mercury%20In%20Vaccines.asp

Bush will VETO similar Mercury Law

12 http://www.polioeradication.org/content/publications/OPVCessationFrameworkEnglish.pdf
WHO Cessation of Oral (live) polio vaccine..policy paper.

13 http://www.polioeradication.org/content/fixed/opvcessation/opvcessation.asp Oral Polio Vaccine Cessation
14 http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5010a1.htmvaccinia smallpox CDC info

(15)
http://en.wikipedia.org/wiki/Swine_flu Swine Flu Vaccination

(16) http://www.haverford.edu/biology/edwards/disease/viral_essays/warnervirus.htm The Sky is Falling: An Analysis of the Swine Flu Affair of 1976, by Joel Warner

(17) http://www.monitor.net/monitor/free2/dpt.html The Tainted History of the DPT Vaccine by Harold Stearley

(18) http://vaccineawakening.blogspot.com/2007/06/at-risk-truth-about-vaccines-lawsuits.html At Risk: Truth About Vaccines, Lawsuits & Shortages Barbara Loe Fisher

(19) http://en.wikipedia.org/wiki/Vaccine_court Office of Special Masters of the U.S. Court of Federal Claims,

20) http://www.hrsa.gov/vaccinecompensation/table.htm Vaccine Injury Table outlining which vaccine related injuries are to be compensated.

21
http://www.uscfc.uscourts.gov/OSM/Autism/Autism%20Update%20-%20September%2028,%202007.pdf Current status of 4900—claims for vaccine injuries resulting in autism spectrum disorder before US Court of Federal Claims, Special masters Patricia Campbell Smith, Denise Vowel and George L Hastings Jr. Ruling is expected after Jan 15, 2008.

22) ftp://autism.uscfc.uscourts.gov/autism/index.html . Audio and written transcripts of this first test case. the Cedillo Case No. 98-916V are available at this page:

23 http://www.ccandh.com/default.asp. Homer legal web site. news and links relating to vaccine litigation.

24 http://www.ccandh.com/decisions.asp Homer legal website; This page contains a listing of federal vaccine court decisions with summary and full pdf file of transcripts.

25 http://www.cbo.gov/ftpdocs/86xx/doc8641/09-20-ConradLTpresenceinIraq.pdf
The Possible Costs to the United States of Maintaining a Long-Term Military Presence in Iraq September 2007

26 http://www.thoughtfulhouse.org/supporting_research.htm#measles
references pertaining to measles MMR vaccine and autism. The vaccine strain of measles virus has been found in 85% of samples taken from the guts of children with regressive autism, according to Dr. Stephen Walker of the Wake Forest University School of Medicine.The study replicates findings made by Dr. Andrew Wakefield, a gastroenterologist, in 1998, and by Prof. John O’Leary, a pathologist, in 2002.

27) http://www.pubmedcentral.nih.gov/articlerender.fcgi?tool=pubmed&pubmedid=11950955

Mol Pathol. 2002 April; 55(2): 84–90. Potential viral pathogenic mechanism for new variant inflammatory bowel disease V Uhlmann,1* C M Martin,2* O Sheils,2 L Pilkington,1 I Silva,1 A Killalea,1 S B Murch,3 J Walker-Smith,4 M Thomson,4 A J Wakefield,4 and J J O'Leary1

Results: Seventy five of 91 patients with a histologically confirmed diagnosis of ileal lymphonodular hyperplasia and enterocolitis were positive for measles virus in their intestinal tissue compared with five of 70 control patients. Measles virus was identified within the follicular dendritic cells and some lymphocytes in foci of reactive follicular hyperplasia. The copy number of measles virus ranged from one to 300 000 copies/ng total RNA. onclusions: The data confirm an association between the presence of measles virus and gut pathology in children with developmental disorder.

28 http://www.nature.com/mp/journal/v7/n2s/pdf/4001179a.pdf

VACCINES AND AUTISM Detection of measles virus in children with ileo-colonic
lymphoid nodular hyperplasia, enterocolitis and developmental disorder
Molecular Psychiatry (2002) 7, S47–S48. Martin CM, Uhlmann V, Killalea A, Sheils O, O'Leary JJ.
29 http://en.wikipedia.org/wiki/MMR_vaccine
wikipedia MMR vaccine

30 http://www.nature.com/mp/journal/v7/n2s/pdf/4001181a.pdf
VACCINES AND AUTISM MMR vaccine and autism: a review of the evidence for a causal association Molecular Psychiatry (2002) 7, S51–S52 CDC finds NO causal association F DeStefano National Center on Birth Defects and Developmental Disabilities, CDC

31 http://www.medscape.com/viewarticle/545428

New Data refutes Measles Virus from Vaccine in Children with Autism

32
http://pediatrics.aappublications.org/cgi/content/full/118/1/e139

PEDIATRICS Vol. 118 No. 1 July 2006, pp. e139-e150
Pervasive Developmental Disorders in Montreal, Quebec, Canada: Prevalence and Links With Immunizations Eric Fombonne, MDa, Rita Zakarian, MEda, Andrew Bennett, PhD, CPsychb, Linyan Meng, MSca and Diane McLean-Heywood, MAb The findings ruled out an association between pervasive developmental disorder and either high levels of ethylmercury exposure comparable with those experienced in the United States in the 1990s or 1- or 2-dose measles-mumps-rubella vaccinations.

33 http://www.cispimmunize.org/fam/autism/a_wake.html
The "Wakefield" Studies: Studies Hypothesizing That MMR Causes Autism Dr. Paul Offit, M.D., FAAP, Chief of Infectious Diseases and Director of the Vaccine Education Center at Children's Hospital of Philadelphia. Those who claim that MMR causes autism often cite two papers by Andrew Wakefield and colleagues. This section summarizes those studies and lists their critical flaws.Conclusion; autism is not caused by thimerosol vaccines

34 http://www.immunize.org/index.htm
Web site which states that Autism not caused by vaccines, funded by CDC

(35) http://www.ama-assn.org/ama/pub/category/13697.html
The relationship between the MMR vaccine and autism
From The Vaccine Education Center Newsletter
AMA page denying link between thimerosol vaccines and autism

(36)http://www.safeminds.org/pressroom/vaccine-study.html
VACCINE STUDY IN NEW ENGLAND JOURNAL OF MEDICINE WRONG IN CONCLUDING MERCURY EXPOSURES ARE HARMLESS, STATES SAFEMIN"Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years," appearing in the New England Journal of Medicine (NEJM, 9/27/07 issue), DS

A Sept 2007 NEJM article speaks against the notion that thimerisol containing vaccines cause neurological problems.

(37) http://content.nejm.org/cgi/content/abstract/357/13/1281
Volume 357:1281-1292 September 27, 2007 Number 13
Early Thimerosal Exposure and Neuropsychological Outcomes at 7 to 10 Years

38 http://www.safeminds.org/pressroom/ehp0114-a00412.pdf

VOLUME 114 | NUMBER 7 | July 2006 • Environmental Health Perspectives
diagram of autism epidemic rise

39 http://www.youtube.com/watch?v=sJIXEyXE4Vk
BioMedMom

40 http://www.safeminds.org/mercury/
Critical Issues, Mercury from Safe Minds.org
41 http://www.vaccinationnews.com/DailyNews/October2001/WhatDocMayNotTell.htm
Link to Stephanie Cave Book, What Your Doctor May Not Tell You About Children's Vaccinations, by Stephanie Cave, M.D., F.A.A.F.P and Deborah Mitchell.

42 http://www.youtube.com/watch?v=aDY7mst7ytg&mode=related&search=Megson%20Autism%20Vaccines

Dr. Mark Geier Speaks at Mercury-Free Vaccines Rally

43
http://www.youtube.com/watch?v=i6yIncJnx4U&mode=related&search=
Dr. Mary Megson Speaks on Autism Epidemic and Vaccines
44
http://www.youtube.com/watch?v=GHMWDBJzh7s&mode=related&search=Megson%20Autism%20Vaccines
Boyd Haley, PhD Speaks at Mercury-Free Vaccines Rally Urinary Porphyrin Profile

45
http://www.youtube.com/watch?v=85tgwh3HpsM&mode=related&search=
Mercury toxicity video How Mercury Kills the Brain ~ Autism

46 http://www.mothering.com/sections/experts/tenpenny-archive.html#doctor-fears Sherri J. Tenpenny, D.O. Vaccinations, Alternative Medicine

47 http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=17885929
J Toxicol Environ Health A. 2007 Oct;70(20):1723-30. A prospective study of mercury toxicity biomarkers in autistic spectrum disorders. Geier DA, Geier MR.

48 http://www.mercury-freedrugs.org/docs/07930_PR_UrineTestingConfirmsAutismIsMercuryPoisoningb.pdf

This study utilized urinary porphyrin profile analysis (UPPA) to assess body-burden and physiological effects of mercury in children diagnosed with ASDs.

49 http://www.youtube.com/results?search_query=signs+of+autism&search=Search Signs of Autism U-Tube

50 http://www.autismwebsite.com/krigsman/
Video:Current Concepts in the Treatment of Autistic Spectrum Associated Enterocolitis, Arthur Krigsman, M.D.Presented at DAN conference 2004. next meeting appearance National Autism Association November 9-11, 2007, Atlanta

52 http://www.thoughtfulhouse.org/bio_akrigsman.htm
Arthur Krigsman MD Web Site, pediatric gasteroenterologist

53 http://en.wikipedia.org/wiki/Arthur_Krigsman
Arthur Krigsman MD Gasteroenterologist

54 http://www.greatplainslaboratory.com/home.htm Great Plains Lab web site

55 http://www.greatplainslaboratory.com/bookstore/autism.asp#biologicalTretments
Biological Treatment of Autism by William Shaw PhD

56 http://www.autism101manual.com/ The Official Autism 101 Manual is the most comprehensive book on Autism"

57 http://www.huffingtonpost.com/robert-f-kennedy-jr/attack-on-mothers_b_52894.html?view=screen
Robert F. Kennedy Jr Attack on Mothers The poisonous public attacks on Katie Wright this week--for revealing that her autistic son Christian (grandson of NBC Chair Bob Wright), has recovered significant function after chelation treatments to remove mercury -- surprised many observers unfamiliar with the acrimonious debate over the mercury-based vaccine preservative Thimerosal. But the patronizing attacks on the mothers of autistic children who have organized to oppose this brain-killing poison is one of the most persistent tactics employed by those defending Thimerosal against the barrage of scientific evidence linking it to the epidemic of pediatric neurological disorders, including autism. Mothers of autistics are routinely dismissed as irrational, hysterical, or as a newspaper editor told me last week, "desperate to find the reason for their children's illnesses," and therefore, overwrought and disconnected.

59 http://www.youtube.com/watch?v=QWG-SWQ3vSs&mode=related&search= Christian and MAkena Non verbal aggressive little guy has turned into a wonderful healthy little boy with the help of the specific carbohydrate diet, vitamins, supplements, chelation therapy, ABA, Occupational and Speech therapy.

60 http://www.mothering.com/articles/growing_child/vaccines/biochemistry.html Interview with Stephanie Cave MD

61 http://www.mothering.com/sections/experts/tenpenny-archive.html#doctor-fears
Sherry Tenpenny. In 1987, the World Health Organization advocated the combined administration of Vitamin A with the measles vaccine. When a dose of 100,000 IU of Vitamin A is given with the vaccine, lower rates of side effects occur, and antibodies still develop. Therefore, be sure to give your child is given Vitamin A on the day s/he receives the vaccine. I would also suggest giving powdered Vitamin C (10mg per pound), for 3 days before, the day of, and for 5 days after any vaccine.
If you chose to vaccinate, I recommend that you wait until your child is at least 6 months of age, preferably older. Do only one vaccine at a time, at least a month apart

62 http://jeffreydach.com/2007/05/06/jeffreydachdrdachvaccinehpv.aspx
Guard Your Daughters from Gardasil

63 http://en.wikipedia.org/wiki/Ignaz_Semmelweis Ignaz Semmelweiss

64
http://www.jameslindlibrary.org/trial_records/17th_18th_Century/lind/lind_1753_commentary.html James Lind and the story of Scurvy

65
http://www.drpasswater.com/nutrition_library/homocysteine.html
Kilmer McCully MD and the discovery of the Homocytseine cause for heart disease

66
http://www.medicalantiques.com/medical/Scarifications_and_Bleeder_Medical_Antiques.htm

(67) http://www.ima.org.il/imaj/ar99nov11.pdf
Wakefield AJ and Montgomery SM. Autism, viral infection and measles mumps rubella vaccination. Israeli Medical Association Journal 1999;1:183-187

(68)

http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=17885929
J Toxicol Environ Health A. 2007 Oct;70(20):1723-30. A prospective study of mercury toxicity biomarkers in autistic spectrum disorders. Geier DA, Geier MR.

(69)
http://www.mercury-freedrugs.org/docs/07930_PR_UrineTestingConfirmsAutismIsMercuryPoisoningb.pdf

Press Release Contact: September 30, 2007 WASHINGTON, DC – A new peer-reviewed scientific/medical case study confirms that many children with autistic spectrum disorders (ASDs) suffer from mercury poisoning. The new study, “A Prospective Study of Mercury Toxicity Biomarkers in Autistic Spectrum Disorders” by Mr. David A. Geier and Dr. Mark R. Geier has been published in the most recent issue of the Journal of Toxicology and Environmental Health, Part A (volume 70, issue 20, pgs 1723-1730).

70) http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=9756729&ordinalpos=3&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Uhlmann V., Martin C, Shiels, Wakefield AJ, O’Leary JJ. Possible viral pathogenesis of a novel paediatric inflammatory bowel disease. Molecular Pathology 2002;55:84-90
71) http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12849883&ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Singh VK, Lin SX, Yang VC. Serological association of measles virus and human herpesvirus-6 with brain autoantibodies in autism. Clin Immunol Immunopathol. 1998;89:105-8.
===

72) http://www.ncbi.nlm.nih.gov/sites/entrez?cmd=Retrieve&db=pubmed&dopt=AbstractPlus&list_uids=12849883&query_hl=43
Singh VK, Jensen RL, Elevated levels of measles antibodies in children with autism, Pediatric Neurology, 2003;28:292-294.
----

73)
http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=12145534&ordinalpos=2&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_RVDocSum
Abnormal measles-mumps-rubella antibodies and CNS autoimmunity in children with autism. Singh VK, Lin SX, Newell E, Nelson C.Department of Biology and Biotechnology Center, Utah State University, Logan, Utah 84322, USA. singhvk@cc.usu.edu, J Biomed Sci. 2002 Jul-Aug;9(4):359-64.

74) Wakefield, A.J., et al.Ileal-lymphoid-nodular hyperplasia, non-specific colitis, and pervasive developmental disorder in children Lancet 351: 637-641, 1998.
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http://pediatrics.aappublications.org/cgi/content/full/107/5/e84

PEDIATRICS Vol. 107 No. 5 May 2001, p. e84 ELECTRONIC ARTICLE:Measles-Mumps-Rubella Vaccine and Autistic Spectrum Disorder: Report From the New Challenges in Childhood Immunizations Conference Convened in Oak Brook, Illinois, June 12-13, 2000 Neal A. Halsey, MD, Susan L. Hyman, MD, and the Conference Writing Panel Conclusions.

Although the possible association with MMR vaccine has received much public and political attention and there are many who have derived their own conclusions based on personal experiences, the available evidence does not support the hypothesis that MMR vaccine causes autism or associated disorders or IBD. Separate administration of measles, mumps, and rubella vaccines to children provides no benefit over administration of the combination MMR vaccine and would result in delayed or missed immunizations.

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http://www.vaproject.org/thrower/mmr-briefing-20070430.pdf

Regressive Autism, Ileal-Lymphoid Nodular Hyperplasia, Measles Virus and MMR Vaccine Summary of Published Studies Offering Evidence for Linkages By David Thrower

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Roger Federer, Ranked Number One

The number one ranked tennis player, Roger Federer, swept the Australian Open, Wimbledon and the U.S. Open in all three years, 2004, 2006 and 2007.(1)(2)

What is Roger's Secret Weapon?

Of course, Roger Federer is a gifted athlete, but could he have a secret weapon that gives him an edge on the tennis court? You might be surprised to know that Roger Federer makes use of gadget called a BEMER. This is a portable pulsed magnetic field device which speeds healing of muscle and tendons after tough tennis matches. According to the BEMER web site, Roger and many other athletes have been using a portable pulsed magnetic therapy unit regularly. (3)

Horse Racing and Pulsed Magnetic Wave Devices

This type of therapy for sports injuries is nothing new. There is big money in Horse Racing, and trainers give their horses pulsed magnetic therapy to gain an edge on the track. Benefits include faster recovery time from sports injuries, improved blood flow, improved nerve regeneration, and faster wound and fracture healing. (4-11)

Dan Clark MD and the BioEnergetic Medicine Conference

I learned about Roger Federer using the BEMER at Dan Clark’s BioEnergetic Medicine Conference in Orlando. (15)

Robert O Becker, M.D., The Body Electric

Electromagnetic radiation as a therapeutic device wasn’t accepted by mainstream medicine until 1985 when Robert O Becker, M.D. discovered that non-united bone fractures heal with pulsed EMF electrical stimulation. This is now standard practice in all hospitals. Becker’s books, The Body Electric in 1985, and Cross Currents in 1990, broke new ground, and the 3 decades of research since then have shown pulsed EMF to be effective for non-united bone fractures, relief of musculo-skeletal pain, migraine headaches, low back pain, depression, wound healing, improvement in blood flow and nerve regeneration, to mention a few. Becker discovered that weak electric currents recruit stem cells which differentiate into the body part requiring healing. Becker also discovered a second nervous system in the body which corresponds to the Chinese acupuncture meridians. (9-14)(63-71).

Electromagnetic Waves are the Basis of the Chemical Bond

Although modern science began with Newton’s laws of mechanics in 1687, Michael Faraday’s principles of electromagnetic induction were discovered only recently in 1831. Since then, Einstein and quantum mechanics further changed our understanding of matter, energy, and the universe. Paradoxically, the electron and all electromagnetic energy are both particle and wave, and the electron’s wave function derived from quantum mechanics is the basis of the chemical bond, first described by Linus Pauling. The chemical bond is now understood as sharing electrons (electromagnetic energy wave forms) between two atoms or molecules. (16)(17)(18-21A)

Electro-Magnetic Energy Use in Diagnosis

We have been using electromagnetic energy for medical diagnosis since the beginning of modern medicine. For example, the Electrocardiogram (EKG) and Electroencephalogram (EEG) both record electrical activity from body parts. The CAT scanner makes an image by passing electromagnetic radiation through a body part. The MRI scanner makes an image by pulsing electromagnetic energy through the body and then “listening” for the emitted energy signal. The mass spectrograph, a primitive form of MRI machine is used daily in the hospital lab for routine blood testing.

Electromagnetic Energy is Essential for Life

When we bask in the sun, and our skin makes vitamin D from sun light, this is electromagnetic radiation driving a bio-chemical reaction in our body. Photosynthesis is another example of absorption of electromagnetic radiation to form carbon bonds in plants. As a matter of fact, all biochemistry can be explained as electrical interactions between outer shell electrons. Electromagnetic energy is a basic part of the biochemistry of life.

BEMER and ONDAMED

One elementary problem with pulsed electro magnetic therapy as a treatment is: how do we determine the exact pulse frequency to be used? The BEMER device steps through a series of pre-set frequencies. Another device called the Ondamed uses a more s