Finally, a good doctor has written about one of the many dangerous forms of quackery being spread in Goa and Goan forums to gullible folk. Here is a nice article by Dr. Francisco Colaco exposing the bogus nonsense called chelation therapy:
http://www.epaperoheraldo.in/Details.aspx?id=15896&boxid=153945593&uid=&dat=05/19/2014 Heart Chelation: A pie in the sky? by Dr. Francisco C. Colaco QUOTE By now most of us have heard of “Chelation treatment centres” that claim they can effectively “ bypass bypass surgery”. Such facilities have mushroomed all over the world and there are at least three clinics doing roaring business in Goa. “ You can dissolve your heart blockages without the need of open- heart surgery”, the proponents vouch. Are these claims well founded or just a pie in the sky? Is there medical evidence to substantiate these claims? Or is this another instance of dubious medicine with “ fools rushing in where angels fear to tread”? Heart attacks happen when the flow of oxygen- rich blood to a section of heart muscle becomes blocked. It is thought that by year 2020 India may become the “ heart disease capital of the world”. Not only heart attacks will here occur in younger diabetics, but an accelerated form of the killer- disease is likely to take a heavy toll. Predictably, more and more patients are being subjected to CABG (coronary artery bypass surgery). CABG is a procedure to restore blood flow and reduce the risk of death from coronary blockages. Arteries or veins from elsewhere in the patient's body are grafted to the coronary arteries to “ bypass” narrowings and improve the blood supply to the heart muscle. This surgery can be performed with the heart “ stopped” ( with the patient hooked to a “heartlung machine”) or on a “ beating heart” (the so- called "off- pump" surgery). CABG has admittedly its own morbidity and mortality. Whenever someone is advised CABG, a natural reluctance overcomes the patient to undergo invasive surgery. Therefore, the sufferers, on their own, or counseled by well-meaning friends (mostly non-medical), seek alternative forms of therapy. Plentiful advice – on blockages being dissolved without surgery – is on offer, from exotic concoctions to enemas! Some take recourse to “healers” and the gullible are led to believe their blockages are “cured”. That many of them later die a sudden unheralded death is another matter… What about “ Chelation therapy”? Is it just another fad? Chelation involves the administration of ethylene-diamine tetraacetic acid (EDTA) into the bloodstream. It reportedly latches onto heavy metals and toxins that can cause free radical damage to the arteries and thus slows the process of arterial hardening. EDTA is delivered through 40 intravenous infusions over a 28-month course. Each infusion administered on an outpatient basis costs around Rs 2500. Antioxidant vitamins and mineral supplements are added to the infusion. After anecdotal reports claiming benefits of Chelation therapy, the medical community took upon itself the task of conducting a scientific trial called TACT (Trial to assess Chelation therapy). The trial lasted 10 years, cost approximately $31.6 million and its results were recently published in the Journal of the American Medical Association. Subjects randomly assigned to active Chelation infusions showed a slight drop in all cause mortality, incidence of heart attacks, the need for coronary revascularization and hospitalization for angina. Another sub-study of TACT further propelled chelation into the limelight because of its extraordinary effects in diabetics. At first blush, the results seem dramatic. But, there remain doubts and unanswered questions. Results were not statistically significant; it took an awful long time to achieve the desired benefits; no “check” angiograms were done to prove the veracity of claims; a good number of patients dropped out unconvinced of its benefits. Significantly, the USA FDA does not approve Chelation for heart blockages and insurance companies do not cover it. More notably, Dr. Lamas, the TACT study’s lead author, backed away from the idea of making Chelation a standard option. Dr. Steven Nissen, head of cardiology at the Cleveland Clinic holding an even darker perspective lamented that the dubious study could be used to market a potentially dangerous and expensive treatment to patients. Dr. Herrmann, an eminent cardiologist at the University of Pennsylvania, sums up: “I currently don’t recommend Chelation therapy for my patients and no study can change my mind.” Chelation proponents allege that opposition by mainstream doctors is because of their fear that an “effective” alternative will deprive by-pass surgeons of their livelihood. It will be long until the dust finally settles. Until then let’s assume “an ounce of prevention is worth a pound of cure”. It will do us well to remember that there are more established ways to get rid of heart attacks. For example: Get active, eat judiciously, don't smoke, control cholesterol, manage blood pressure, lose weight, reduce blood sugar. If you already have a heart problem take a Statin and a daily Aspirin. If you take these steps, current evidence says that you are unlikely to get any extra benefit from Chelation therapy. In contrast there’s overwhelming evidence on the enormous benefit of lifestyle changes and simple medications. And therein lies the magic bullet that will protect us not only from heart disease but will also spare costly surgery and ensure a clean bill of health. An ounce of prevention is worth a pound of cure. It will do us well to remember that there are more established ways to get rid of heart attacks. For example: Get active, eat judiciously, don't smoke, control cholesterol, manage blood pressure, lose weight, reduce blood sugar UNQUOTE Cheers, Santosh
