2007 (Washington DC)
RRP Focus Session
The following is a summary of material that was shared at “RRP Focus Session event in Washington D.C. on September 15, 2007.
This year’s event was produced (planned, facilitated and paid for) by the RRPF. It was supported by grants from Medtronic Technologies.
The next RRP Focus Session will be produced by the RRP ISA.
Although a few people came and went, this reviewer counted between 22-25 RRP patients and their families, along with between 8-10 physicians and researchers. This included the speakers, for a total of around 35 attendees.
The following summaries are presented as highlights only . Details are provided in the PowerPoint, when available. The RRPF did not make any MP3 files, which were part of the 2005 Focus Session sponsored by RRP ISA.
Merck and Dr. Richard Schlegel declined to have their PowerPoints published. The presentation sequence below is different from that shown in the agenda.
Readers are strongly encouraged to consult the PowerPoints/Documents for more information.
1.) Bill Stern RRPF Executive Director
Bill Stern thanked the audience for attending, acknowledge the grant from Medtronics with gratitude, and walked us through the Foundation's priorities, touched on the listserv, explained the database, described concerns involving pulmonary RRP, and listed RRPF research support domains and areas of interest.
2) Michael Green, MSW, LICSW Intl RRP ISA Center's President & Executive Director
He went on to talk extensively about the therapeutic use in RRP of Gardasil and artemisinin, which he had used with dramatic success.
RRP ISA reported on the first human use of Gardasil and artemisinin together, which seemed to produce stunning results. It was the cornerstone of the presentation.
Dr. Richard Schlegel of Georgetown University confirmed in his own presenation (same event) that Michael's reasoning and conclusions looked sound--that Georgetown University's own research confirmed that VLP L1 vaccine like Gardasil could indeed be powerfully therapeutic. In addition, when it was his turn to present, Dr. Schlegel said that artemisinin, in studies done with dogs and in other published research, looked like a potent adjunctive treatment for HPV disease/RRP.
Michael emphasized the need for better education relative to HPV, and for Merck and other venues to properly recognize the role of HPV in a variety of cancers, etc. Michael called an educational initiative (a Task Force?) involving RRP ISA, the RRPF, the RRP Taskforce, the Papillomavirus Society and a host of cancer coalitions.
(3) Craig Derkay, MD Professor and Vice-Chairman. Eastern Virginia Medical School, Chairman of RRP Task Force
Dr. Derkay recapped the function of the RRP Taskforce and some of its accomplishments. He went on to discuss post-licensing suggestions for RRP vaccine trials, cidofovir and toxicity issues, Celebrex, etc. Much data and summary of recent research was offered. His PowerPoint is fairly self-explanatory.
(4) Farrel Buchinsky, MD. Pediatric Otolaryngologist, Allegheny General Hospital in Pittsburgh, PA.
Dr. Buchinsky's PowerPoint recapped the details of his genetic research. It is fairly self-explanatory. RRP ISA was acknowledged as a funding agent for this research.
(5) Nigel Pashley, MD. Private Practice, Denver
Dr. Pashley stated that his mumps/MMR vaccine resulted in remission of 78% in kids, 75-80% in adults. He defined remission of two visits without papillomas separated by at least 6 months. He then went on to suggest that he had certain insights into the mechanism of action of MMR. He announced he is now using up to 29 ampules of MMR on adult patients in any one procedure.
[Editor's note: Many of Dr. Pashley's patients, as reported to the databases of the RRPF and RRP ISA, show results that suggest nothing even remotely supporting his claims. Several appear to have had >20 procedures and are NOT in remission. The success rate, based on these reports, would appear to be much less than the represented rates.
History: In 2004, when Dr. Pashley presented at the RRP Focus Session, he claimed adults were getting an 85% remission rate on MMR, and that they were getting up to 15 ampules of MMR at a time. Now, in 2007, he revealed that he is now using up to 29 ampules at any one time, and ostensibly not doing much better that his reported response as before. In 20 procedures, it would appear that he might now give his adult patients as much as 580 ampules (29 X 20). That's up from nearly 300 ampules in just two years.
Dr. Pashley seems to have a form of Moore's Law going for himself, where he keeps claiming astronomical rates of remissions yet doubles the dose of MMR every 2-3 years [ostensibly without getting any substantially higher remissions]. At the 2007 Focus Session, he said he now gives adults 29 MMR injections in a single procedure (he explained how), which rivals Intel's goal of putting a jillion transistors in a single chip.
But 29 ampules in any one procedure does seem a bit over-the-top. A lingering impression was that Dr. Pashley really does care, but he also feels messianic. Perhaps the reason why this approach hasn't been picked up in the larger medical community is because self-proclaimed medical messiahs, who simultaneously present with manic zeal, justifiably tend to be viewed with suspicion.
Then there are the several physicians on the RRP Task Force who have stated that they have not been able to replicate the spectacular remissions Dr. Pashley has claimed to induce.
Why would Dr. Pashley have nearly doubled the dose if the results previously were so wonderful? Data disconnects evidently mean little here.
What about side-effects?
Dr. Pashley emphatically denied any observable side-effects from MMR. It seems to be Dr. Pashley's practice, however, to ignore patient-reported side-effects, because as an audience member, I DID report multiple side-effects from the single MMR treatment I had.
Much of Dr. Pashley's far-ranging speculations on AIDS/HIV and "memory T-cells" sounded pretty far out. To this observer, he seemed to be someone who hadn't a clue as to what is happening, but who wanted to look "smart, sophisticated and informed."
It is sad when any adjunctive modality that can indeed claim some measure of success (MMR seems indeed sometimes to have worked when cidofovir didn't) has to be dressed up in any kind of hype.
What we DO know is that Dr. Pashley works with great precision in the laryngeal ventricles, where papillomas like to hang out. He's good in the ventricle, although he goes into a Dr. Strangelove-mode in the anterior commissure, where the vocal cords come together. There, he has said that it is perfectly fine to laser both cords at the same time, flying in the face of the due diligence guidelines touted in practice standards that most laryngologists follow. One cannot call him a great surgeon given his devil-may-care approach at the anterior commissure, but one can call him a very careful surgeon in the ventricles (that's seemingly rare in RRP-circles, and Dr. Pashley deserves credit for this). That fact alone could have been responsible for much of his claimed success with MMR, thus confounding much of his claims about MMR's success-rate.
Even despite the careful ventricle work that Dr. Pashley does, however, MMR seems to have greatly helped some patients. But the fact that MMR is reported to work on Dr. Pashley's patients though some other doctors have not been able to replicate those claims casts a pall on whether the MMR really did the trick--to the level the Dr. Pashley believes it operates--or whether it was something else unique to Dr. Pashley though clearance of the ventricle.
If it were totally benign, all would be relatively well, but the "MMR protocol" can, in the opinion of some respected physicians and researchers, seriously discombobulate the immune system. No one has systematically studied its long term effects from the point of view of safety.
See Informed Consent, written by Dr. Bettie Steinberg, for what we consider to be a strong critique of the kind of "procedures" employed in this protocol. An equally strong cautionary statement from Dr. Vincent Bonagura, a highly respected immunologist, can be found here,
For more on Dr. Pashley's unique approach, please see the MMR Section on our Treatment page. You need to make your own judgments, of course.
If you absolutely MUST go this route, why not use the mumps vaccine instead of MMR? At least it doesn't contain three live viruses as MMR does, and it seems not to carry the risk of such serious side-effects as MMR. Ironically, Dr. Pashley himself, in the 2004 RRP Focus Session, pegged the remission rate for mumps at a mark that came relatively close to his already seemingly inflated MMR claims.]
(6) Mark Shikowitz, MD Long Island Jewish Dept. of Otolaryngology (LIJ)
Dr. Shikowtix presented on LIJ's research in using Celebrex on RRP. The patient is his own control. Growth rates are measured by the Kashima scale and have been done on three patients. LIJ recently was aarded a NIH grant. Dosing is once a day (400 mg) rather than two, as this is thought to mitigate cardio risk. Debulking is routinely done. Preliminary results for the three patients were reported. The PowerPoint speaks for itself.
(7) Carter Wright, MD Wake-Forest Univ. Health Services
Photo PowerPoint Video 1 Video 2
Dr. Wright presented on the CO2 OmniGuide Laser. One advantage is that it does not penetrate deply. 12-16 watts is similar to a regular CO2 lasre at 4-6 watts. It allwos for in-office procedures (no OR). [Ed Note: There are at least 5 outpatient lasers, including PDL, Omni-Guide and 3 others not covered in this Focus Session. The video that Dr. Wright presented is worth looking at. ]
(8) Richard Schlegel, M.D. PhD Professor and Chair, Department of Pathology, Georgetown University Medical School
Dr. Schlegel is working under a Bill and Melinda Gates Foundation grant to study HPV. In this presentation, funded through the National Cancer Institute, he explained his research in using L1 VLP vaccine. The PowerPoint is off-limits for publication here because of the fact that the reseacrh is up for publication. Dr. Schlegel's presentation was quite detailed, however, showing that a vaccine like Gardasil might indeed be therapeutic. He noted that immunoglobulins are irrelevant to therapy. Artemisinin has been very helpful in putting canine RRP in remission. He supported RRP ISA's research proposal to study Gardasil and artemisinin in tandem.
We hope to acquire the author's permission to post the PowerPoint at a later time.
(9) Matthew Brigger, M.D. Massachusetts Eye and Ear Infirmary, Harvard Medical School
Dr. Brigger's PowerPoint pretty much speaks for itself. This describes the research design and protocol. [Ed. note: Concerns have arisen about PDL. See Learn>Treatment Strategies for more.]
(10) Dalya Guris, MD, MPA Merck
Dr. Guris spoke about Gardasil. Merck plans to use insurance databases to track epidemiological factors following release of Gardasil and its effect on RRP. Merck is supporting a sero-assay that Dr. Buchinsky is helping to design having to do with antibody presence. [Ed. note: We do not have the author's permission to use Merck's PowerPoint.]
Nventa had a schedule conflict and didn't show. They did provide a Document to reviewHspE7 (new version) may be released for phase 1 trials in 2008.