by Karl Loren
The material below was published on this page many years ago. Since then, starting in early 2004, Jean Ross, wife of Karl Loren, was diagnosed with cancer of the esophagus -- considered one of the most deadly of cancers -- she was told, at the start, that her chances of survival were less than 20% for two years.
Despite our years of preaching about the evils of chemotherapy and radiation, Jean choose to go that route. That story is fully published and covers hundreds of pages on several different web sites. You can get a good start on learning about Jean's Journey through chemotherapy and radiation, leading to expected death in a Hospice starting HERE.
Then the miracles started to occur, including the use of Taheebo Life Tea, but more importantly for this page about PET scans when Jean had the PET scan that showed she was free of cancer -- after several months of both conventional and alternative therapy. That PET scan story is HERE.
The page which describes this remarkable event, and how we arrived at that point is well worth your reading -- it is HERE.
Now, I want to write a bit about how the PET scan works in the area of cancer.
I have written literally thousands of pages about cancer since writing HERE about the PET scan. My wife, Jean, has had conventional treatment for her cancer -- that included many CAT scans, X-Rays, Radiation, and two PET scans. So, I've learned about these things far better by experiencing them than studying books and web sites.
Cancer cells grow very rapidly -- that is, the multiply very rapidly. The growth of any part of the body calls for more energy and nutrients than the more slowly-growing areas of the body. Cancer cells are among the most rapidly multiplying cells in your body -- thus they demand a great deal of energy to keep multiplying.
When you think of energy, just think of sugar. It is the glucose (sugar) in your body thar provides energy -- and cancer cells demand and get a very large supply of it.
So, if you could figure a way to tracking which parts of the body are using more sugar than other areas, you would have a clue as to where cancer might exist.
That is what the PET scan does.
You start the PET scan by NOT eating for at least 6 hours before the test -- so the body is low on energy -- low on sugar -- ready to receive sugar and spread it throughout the body to whatever part needs it.
After this period of "no sugar" you receive an injection of sugar water -- but the sugar in this water has been made radioactive -- it is not greatly dangerous, but it is radiation and that is how it works.
You get this injection of sugar water -- then wait for about 40 minutes while the sugar is spreading throughout the body. Since cancer needs more energy (sugar) than most other items in your body, there will be a concentration of sugar in the areas of cancer -- and remember, this sugar is radioactive.
Next you lie on a table that moves you through a large doughnut shaped machine -- it is nothing more than a means of "catching" the radiation that is being emitted from your body because of the radioactive sugar. This radiation is emitting out in a three dimensional structure, so the PET scan machine needs to run your body through the "radiation receiving plates" in the doughnut.
As the table moves you through the doughnut, slowly, your body is radiating energy OUTWARD, from the areas in the body which have attracted the radioactive sugar -- the areas that are consuming the most energy -- the areas of cancer.
It is quite neat! The recording plates pick up these radiations like a camera would record on a negative -- then these recordings are stored electronically (digitally) so that the doctor can "read them."
The doctor, then, simply looks at the energy picture of your body -- finds the "hot spots" and they are the cancer!
The PET scan can detect an area as small as 7 mm, very small. Smaller than that, the PET scan doesn't detect cancer. If the cancer is large, as it was in Jean's case -- about the size of a hot dog, the PET scan can measure the size and the radioactivity -- the PET scan can also tell, in this same way, whether the cancer has spread to other parts of the body. If the cancer has spread, then there would be bright (energy) spots on other organs and in other areas of the body.
After conventional cancer treatment -- intended to kill the cancer cells -- the Oncologist cannot tell if the cancer is dead or not without some sort of test. The PET scan is one of those tests. A new biopsy in the area would be even more accurate and would be indicated after a PET scan shows that there is "probably" no cancer there -- since there are no hot spots of energy.
The biopsy, of course, could cause spreading of cancer but if the cancer has already spread, or it there has been conventional treatment to kill it, then the biopsy is relatively safe. If the biopsy finds no cancerous cells, then the final diagnosis can be quite confident -- no more cancer.
So, the PET scan is a very useful, even if somewhat harmful, test to see what parts of the body are getting extra energy (sugar).
Karl Loren
Cardiovascular Disease
Cardiovascular disease is America's leading cause of disability and death. It results in more premature deaths than any other illness, more than cancer and accidents combined. One million people die of cardiovascular disease each year -- one every 33 seconds. More than 550,000 of these deaths are from heart attack, many occurring in the prime of life; 50 percent of first-time attacks are fatal. Heart disease costs $56 billion annually for hospital, physician, and medical-surgical costs in the United States.
Twenty to forty percent of middle aged people have early or advanced coronary heart disease due to atherosclerosis, most without symptoms or knowledge of their condition. In atherosclerosis, cholesterol builds up in pockets (plaques) embedded in the walls of coronary arteries beneath their inner lining (figure 1).
Figure 1
Heart attacks occur when the plaque lining breaks or ruptures into the artery, forming a blood clot or thrombosis. The clot grows until it blocks the artery, causing heart attack, chest pain, or stroke. Typically, this plaque rupture occurs unpredictably at sites in the coronary artery that are not significantly narrowed and previously caused neither chest pain or other symptoms. Currently, cardiovascular management relies principally on standard stress testing, coronary arteriography, balloon dilation and bypass surgery. While these procedures are sometimes necessary, they have substantial drawbacks. They are invasive, with resulting risk and trauma to the body; they are inaccurate, leading to unnecessary procedures; they are costly; they do not address the basic cause of the disease, do not reverse the underlying atherosclerosis, and do not improve survival.
Stopping the basic atherosclerotic process, stopping heart attacks, stroke and death as prevention or as treatment of established coronary heart disease require both long-term, vigorous lifestyle changes and drug therapy as developed at The University of Texas-Houston Medical School by Dr. K. Lance Gould.
PET Diagnosis and Reversal Therapy
Dr. Gould has developed a revolutionary, non-invasive management of coronary heart disease that overcomes many of the drawbacks of current traditional therapies. His approach is based on:
Positron Emission Tomography (PET) for diagnosis and follow-up,
Dietary-behavioral-pharmacologic treatment for prevention and reversal of atherosclerosis.
PET makes pictures or images non-invasively of the blood flow and/or metabolic activity of the heart using a safe, short-lived radionuclide (figure 2). The resulting image is a three-dimensional picture of the heart's blood flow capacity (figure 3).
Figure 2
Figure 3
The diagnosis of coronary atherosclerosis by PET is astonishingly accurate. It is better than the arteriogram because it identifies effects of diffuse coronary atherosclerosis that are not detectable by coronary arteriography, now shown to miss 79% of this common form of coronary atherosclerosis. The initial PET imaging provides early diagnosis that allows treatment to begin long before symptoms develop. Follow-up imaging definitively indicates whether there is progression (figure 4) or regression (figure 5) of coronary heart disease, and whether more vigorous treatment is needed.
Figure 4
Figure 5
The vigorous dietary and drug treatment regimen relieves pain, partly reverses and prevents additional vascular disease, heart attacks, sudden death and the need for balloon dilation or bypass surgery. It is considerably less costly than these procedures with better outcomes. While PET has been used elsewhere in the country for important brain research, UT-Houston's PET research program is the leader in cardiac research for the comprehensive non-invasive management of heart disease.
Improved Diagnosis
One of the great advantages of PET is its superior ability to diagnose or assess the severity of coronary heart disease early in its development when a patient has the best opportunity for optimal survival and/or quality of life. PET offers diagnosis and follow-up assessment with an accuracy greater than tests using ECG monitoring, traditional nuclear studies, or coronary angiograms. Standard exercise testing with ECG monitoring or standard imaging technology gives erroneous results in 50 percent or more of patients, particularly women. Even standard coronary angiograms are often erroneous: visual estimates of specific arterial narrowing by board certified cardiologists over-estimate the severity of narrowing by as much as 60 percent. Moreover, in 79% of subjects with elevated cholesterol, coronary angiograms fail to identify more general, diffuse build-up of cholesterol throughout the walls of the arteries, a condition which causes most heart attacks and strokes. In contrast, 3-D PET imaging has an accuracy of 96 to 98 percent in identifying the severity of narrowing of coronary arteries. PET also identifies the abnormalities of blood flow in heart muscle caused by diffuse build-up of cholesterol throughout the walls of the artery that are often not apparent on an angiogram (figure 6).
(Figure 6)
Program for Preventing or Reversing Coronary Heart Disease
Since cardiovascular disease is the major killer and cause of disability, this Coronary Disease Reversal Program uses a vigorous approach combining all the major therapeutic steps available - very low fat food, cholesterol lowering drugs, smoking cessation, exercise and stress management - to optimize regression or no progression and minimize the risk of future clinical events. These components of the program are individually planned for each patient depending on his or her time constraints, work demands, prior lifestyle, and personal preferences, thereby increasing compliance. They are adapted for each patient with emphasis on developing knowledge, motivation and active, self maintenance of reversal treatment for coronary artery disease. The principles of reversing coronary heart disease are provided with their individual application and follow up reinforcement, motivation and monitoring by a variable mix of outpatient clinic visits, home lifestyle rehabilitation, intensive telephone or written follow-up locally or at long distance and/or exchange with the private physician, all adapted to individual needs. There is no single, fixed or rigid regimen, diet or method to which all individuals must conform. Multiple subspecialty consultations, special equipment or facilities, group interaction, classroom meetings, unnecessary clinic visits, or excessive time demands or disruption of busy schedules are avoided in this program in favor of integrating essential lifestyle changes and medical management into the individuals daily life at home and work.
Each person is provided an individualized, flexible program incorporating the fundamental steps that do require commitment and thoughtfulness with a minimum amount of time depending on individual circumstances. Successful reversal of cardiovascular disease requires the emotional commitment to live, to understand the fundamentals, to abide by them and to actively manage one's health incorporating current low fat food products, medical knowledge, reasonable self discipline, and cholesterol lowering or cardiovascular drugs.
Although current published medical literature and Dr. Gould's personal clinical experience with many patients support the effectiveness and safety of this approach, some risk of coronary events or worsening chest pain may remain as with balloon dilation or bypass surgery.
COMPONENTS OF THE PROGRAM FOR PREVENTION OR REVERSAL OF CORONARY HEART DISEASE are summarized as follows:
1. MEDICAL EVALUATION.
- History and physical examination
- Review of all current medical data including prior exercise tests, coronary arteriography and laboratory work if available.
- Assessment of lifestyle, risk factors, lipid profile, diet, activity level, smoking risk, stress, hypertension, family history of coronary heart disease and diabetes if present.
- Evaluation of past and current treatment including cardiovascular medications, prior balloon dilation, bypass surgery or recommendations for these procedures for patients needing a second or alternative medical opinion.
2. POSITRON EMISSION TOMOGRAPHY (PET). Non-invasive PET is done as an outpatient service in order to rule out or identify coronary heart disease, it's severity, extent of heart damage and/or salvageable heart muscle, the suitability for the Coronary Disease Reversal Program and/or the necessity of balloon dilation or bypass surgery.
3. EVALUATION OF INDIVIDUAL TREATMENT NEEDED.
- Review of PET images and results with patient.
- Determination of appropriate treatment including cardiovascular and cholesterol lowering drugs, evaluation of the best psychological motivation and plan for lifestyle change, very low fat food, exercise, smoking cessation and stress management. For each individual depending on his preferences and personality, a plan is personally outlined for food at each meal, medications, doses and side effects, one of alternative exercise routines, a motivational plan for no smoking including nicotine patches if necessary, and simple stress modification routines fitting into busy schedules of the practical minded.
- Preparation of written report on results and treatment plan including cardiovascular and cholesterol lowering medications, diet, exercise, lifestyle change, smoking cessation and stress management.
4. LIFESTYLE REHABILITATION REINFORCEMENT and follow-up emphasizing specific components of the reversal program including self maintenance of lifestyle change, low fat food, exercise, no smoking, effectiveness and/or side effects of cardiovascular/cholesterol lowering medications, evaluation of laboratory studies, particularly liver function tests and lipid profile at each of the following time intervals:
- Extended follow-up every month initially for 3 months and then every 3 to 4 months thereafter with personal analysis and adjustment of the reversal program individualized for each person with regard to food, medications, exercise, symptoms and medical management with personalized reinforcement sessions to optimize adherence to the program.
- Additional weekly or monthly telephone or written follow-up by a cardiac team as needed.
- Telephone or written consultation for patient questions or unexpected problems as needed.
- Follow-up diary of diet, exercise, risk factors, cardiovascular and cholesterol lowering drugs, symptoms, side effects and modifications needed in the program tailored for individual needs carried out by cardiac staff reviewing progress with each patient.
5. REPEAT PET SCAN AT 1-2 YEAR FOLLOW-UP is an option to evaluate progress and adjust the lifestyle rehabilitation regimen as needed for the uncommon necessity of balloon angioplasty or bypass surgery due to progression of disease, usually occurring in patients failing to adhere closely to the program.
Cost of the Coronary Heart Disease Reversal Program
There is greater reduction in heart attacks and deaths with reversal treatment than for any other treatment currently used for coronary heart disease, including bypass surgery and balloon dilation at lower cost (table 1).
ONE YEAR COSTS PER PATIENT OF
REVERSAL vs STANDARD TREATMENT
PET + REVERSAL Rx: DIET, DRUGS, LIFESTYLE CHANGE $ 6,300 STANDARD ExTEST, ARTERIOGRAM, DILATION $35,000 STANDARD ExTEST, ARTERIOGRAM, SURGERY $62,750 (Table 1)
The cost of the Coronary Heart Disease Reversal Program ranges from approximately $3800 down to $2000 for the first year depending on the type and intensity of follow-up. In order to minimize the economic burden, the total cost of the program is divided into the initial evaluation-recommendation charge of $1800 with the balance due as needed depending on the intensity of medical management required and/or success of each person in adhering to the program. For initial evaluation, treatment plan, detailed review and recommendations, the initial enrollment charge is $1800 for the first year due as a check made out to The PET Imaging Center. Any balance due over $1800 is billed for each follow-up clinic visit and for routine laboratory work throughout the year at standard charges, including coverage by the participant's third party insurance carrier. The initial $1800 plus costs for follow-up visits and lab tests of the reversal program are for a 12 month period. It does not cover costs of medication, other diagnostic tests, procedures or other routine medical care that must be covered by insurance. As an active incentive, those who adhere to the program with success in achieving the goals usually require less intense management and follow-up, thereby lowering follow-up costs.
By comparison, other programs such as a health spa, fat farm, lifestyle retreat or low fat food resort commonly cost $6,000 or more. No other program integrates lifestyle changes with comprehensive medical-pharmacologic management and follow-up support with on-call availability after hours or by telephone for questions or problems for one year. By further comparison, the costs for physician and staff services for coronary bypass surgery are $10,000 to $15,000 (total costs of $65,000) and for balloon dilation $5,000 to $8,000 (total costs of $35,000) but these procedures do not stop progression of atherosclerosis or prevent heart attacks according to scientific literature.
There is no contract with Medicare for PET or this atherosclerosis program. Reimbursement for direct payments made by the participant for the reversal program will therefore not be submitted to Medicare since there are no CPT codes for this category of service. The Center has no contract with PPO's, HMO's or any other managed care provider.
With your interest and participation, unique individualized services are provided with potentially major impact on your health.
Dr. Gould was far ahead of his time when he first established the scientific basis for and pioneered the use of Positron Emission Tomography for early detection and evaluation of cardiovascular disease, beginning in 1971. Since those experimental beginnings, heart PET and reversal therapy have been well validated scientifically and have evolved to a major clinical service currently attracting hundreds of patients annually from throughout the nation and the world.
For further information, contact:
K. Lance Gould, M.D.
Professor of Medicine
University of Texas Medical School
6431 Fannin, Room MSB 4.256
Houston, Texas 77030
Tel. No. (713) 500-6611
Fax No. (713) 500-6615
--OR--
Mary Haynie, R.N., M.B.A.
Clinic Coordinator
University of Texas-Houston
6431 Fannin, Room MSB 4.256
Houston, Texas 77030
Tel. No. (713) 500-6611
Fax No. (713) 500-6615
E-mail address: mhaynie@pet.med.uth.tmc.edu
Directions to the P.E.T. Center
ystuart@heart.med.uth.tmc.edu. Last modified 9/99.
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