Print

Print


Dennis, the discussion you started is evidence of a large
communication gap between the researchers and the patient community
that needs to be bridged.  We members of the latter group simply
don't know enough about what the former are doing to have any sense
of how far off the "cure" is.

I agree that there will be several "cures".  Based on my limited
understanding, I envision the following three forms, but no time
frames:

1.  Neuroprotective drugs which greatly slow the progress of the
disease.  If PD is diagnosed before the symptoms evolve beyond the
minor nuisance stage, ideally it would be arrested at that point.  I
base this on an article by Dr. Olanow and the late Dr. Marsden, "The
causes of Parkinson's disease are being unraveled and rational
neuroprotective therapy is close to reality" in Annals of Neurology
1998;44(Suppl 1).  The article states that "advancements in science
have provided us with a rather daunting list of neuroprotective
agents" that need to be tested for applicability to PD, so many that
current clinical trial procedures will be a bottleneck.  It seems
implicit in this that quite a few years are needed for testing of
these agents, not only because of the large number of agents to be
tested, but also because of the time needed to verify that the rate
of progress of neurodegeneration, which without such therapy is
usually already rather slow, has gotten acceptably slower.  Such
therapy will arrive too late for use on you and me.

2.  Neural growth factors applied so as to stimulate re-growth of
degenerated tissue.  Should the recent report of an autopsy
of a growth factor trials subject, revealing no effect, be
taken as discouraging?  Maybe just a little tweeking is needed in
order to make it work.  Or maybe not.  I have no infornmation.

3.  Tissue transplants.  I am encouraged by Jim Finn's experience.
However, I don't see surgery as a procedure to apply to several
million patients.

Regarding the urgency, I understand two aspects.  First there is the
personal. I do not want to suffer in my old age, nor do I want
anyone else to, if it can be avoided.

Second is a cost-benefit projection.  The figures that have been
developed show that the costs of developing and administering the
"cure" therapies will be significantly less than the costs of having
PD under the present modes of therapy.

It would be nice to be able to define and outline the remaining
research tasks that lead to conquoring PD, showing their order,
duration and cost.  This would be the plan to conquor PD.  To what
extent it is possible to do this at all would be a good question to
ask the researchers.

Phil Tompkins
Hoboken NJ
Age 61/dx 1990