Fw: Open Letter from Dr. Kolb

[Guest guest]

> June 4, 2001

>

> Ilena Rosenthal

> Director, Humantics Foundation

> 1380 Garret #444

> San Diego, CA 92109

>

> Dear Ms. Rosenthal:

>

> After watching " Storm in a D Cup " on The Learning Channel, I would like to

> propose some suggestions to scientists that may help to resolve the still

> ongoing breast implant controversy, which in my opinion has not ever been

> satisfactorily resolved.

>

> I am a board certified plastic surgeon who is also board certified in

> holistic medicine. I have not only had the opportunity to experience the

> symptoms of silicone immune and neurological disease in my own body when

my

> silicone gel implants leaked, but also have had the opportunity to treat

> over five hundred women with similar illnesses. Subsequently I believe I

> have some insights into this problem that may have been missed by doctors

> who do not treat these women.

>

> I would like to offer the following suggestions. First, any study on

> silicone should only include women who have had implants in at least eight

> to ten years, as it is well documented that in most cases leakage or

> rupture usually does not occur before this time unless the implant is

> subject to some form of trauma. There are studies describing the

lipolysis

> reaction that occurs on the Silastic shell and this lipolysis reaction

> takes time. Studies such as " Silicone Gel Breast Implant Rupture,

> Extracapsular Silicone, and Health Status in a Population of Women " by

Lori

> Brown et al in the Journal of Rheumatology 2001; 28:996-1003, look at such

> a targeted patient population and show an association between fibromyalgia

> and extracapsular silicone from ruptured silicone gel breast implants.

> Second, a less strict definition of connective tissue or autoimmune

disease

> needs to be studied, as the majority of patients do not have a known

> connective tissue disease. The first element of silicone disease has to

do

> with the development of symptoms of systemic candidiasis due to an immune

> dysfunction, which I have found to be associated with depressed natural

> killer T cell levels. We also find at surgery that approximately half of

> the patients' breast capsules culture out pathogenic organisms such as

> Staph aureus and Enterococcus.

>

> I would propose that once the silicone gel leaks out of the implant, a

> chronic immune response occurs that is often associated with local

capsular

> bacterial infection and with systemic and possibly local fungal

infections.

> The patients next experience neurological symptoms that can be explained

by

> the silicone gel migrating directly or via the macrophages into the

> lymphatic and nervous systems. Women with longstanding silicone gel

> exposure have typical neurological problems, usually beginning in the

> extremity on the side of the implant that leaks or ruptures first. Some

> women also have toxicity from platinum and other chemicals that are used

in

> the manufacturing process of the implants. In my experience, the end

stage

> of this disease is an autoimmune condition similar to scleroderma. It may

> be modulated by intracellular bacterial infections that change the

> characteristics of the cell wall and lead to autoimmune symptoms that are

> atypical, in that they do not fall into any known connective tissue

disease

> but are actually very typical for women with silicone immune dysfunction.

> This does not occur right away and may take ten or more years of silicone

> exposure.

>

> The clinical picture we see in these women is that of increased level of

> cytokines which explains why Plaquenil is effective. I believe this is

> also one of the factors, along with the presence of increased silica in

the

> body, which may protect women with implants against breast cancer. Silica

> and other mineral deficiencies are known to predispose to cancer.

>

> It is important to study this problem for three reasons. One is that

> silicone gel implants are being reintroduced into the market without

> understanding what has caused so many women to become ill; and the second

> is that some patients with saline implants are experiencing similar

> problems, especially after trauma, which may disrupt some of the textured

> silicone from the capsule into the systemic circulation and/or lymphatics;

> and third, is the advent of the exciting research on the potential

> protection from breast implants against the development of breast cancer.

> This potential advent indicates the necessity of fully understanding the

> effects of silicone and its breakdown products in the body as this may

> contain the information for an important cancer treatment.

>

> I would propose much more detailed immunological studies of the patients

> with problems as well as a study of the HLA type of the same patients.

Our

> best avenue to serve our patients is to prevent complications even if they

> occur in a minority of our patients, rather than to insist that these

> problems do not exist. Many of my patients have been told by their

plastic

> surgeons and/or rheumatologists that their implants could not have

anything

> to do with their illness, only to discover abnormal bacterial and fungal

> growth around an implant that when removed and properly treated, leads to

> the patients' recovery and greatly improved health. I would encourage all

> of the doctors and scientists in this politically charged issue to focus

on

> the patient to determine what is making them ill, and on the science of

> silicone, so hopefully we may someday safely use this material in the

body.

>

> Sincerely Yours,

>

>

> E. Kolb, M.D., F.A.C.S.

> SEK: tam

>

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