Can our pictures actually achieve anything positive?

[Jeremy Roussak]

Well put, Tony. I've nothing to add to that. Misunderstanding of science, whether deliberate or from ignorance or mere gullibility, is the bane of our age.

Jeremy

[Osprey]

Jobs had cancer of the pancreas. While I'm sceptical about alternative cures, that puts him in the "nothing left to lose" category. Three years ago, the head of the cancer bioinformatics unit across the street diagnosed his own pancreatic cancer. Early diagnosis, knew exactly where to go for the best treatment. With his time as a senior fellow at the US NCI, he had access to all the knowledge... he lasted a year.

Actually he had a neuroendocrine tumor of the pancreas, which may actually have been treatable. From what I've heard he wasted some time with alternative therapies and by the time they got to really treating him, it had metastasized. The whole liver transplant procedure later on tells you there was something very atypical about his pancreatic cancer.

[Rob C]

One thing that I think's worth adding to this discussion - the only thing that, as a non-medic I feel I'm capable of adding with any value, would be this: there's no limit to the value of continued hope. It may or may not cure or help anything physically - that's a separate issue - but it certainly does affect the quality of life of those affected by disease, whether as patient or relative.

Generally, I think it's a good thing that we do not know the time of our ending; however, in the case of knowing one has a terminal illness, I think that the situation changes, and that an educated guess from a specialist could help make those remaining days, months or years better-spent. Of course, few medics would, I'd imagine, feel willing to hazard such a time-guess, especially as the world becomes ever more litigious. And even then, all patients will not be of the same mindset: what would help one make the most of remaining time could as easily drive another into an even worse state of mind.

Thank goodness I don't have to face these ethical dilemmas.

Rob C

[Ray]

Ray, as an individual, you are welcome to your opinion, and to state it.
However, also as an individual, and a medically-trained one at that, I cannot stand by and allow falsehoods and mistruths to be promulgated.

Tony Jay

Fair enough Tony. Since I do my best to take responsibility for my own health, which at my current age of almost 74 is currently fine with no problems that I'm aware of and always has been fine apart from the occasional incidence of flu and the like, and the occasional minor accident, I am also very concerned about any falsehoods relating to health matters because I wish my good health to continue.

I take my health seriously, so naturally I would be very grateful if you were able to prove that fasting cannot cure cancer, and that the suggestion that it can is a load of rubbish.

I hear reports all the time of people who have been diagnosed with cancer but who fail to be cured by conventional medical treatments which often seem to do no more than prolong their life for a few months or a few years. But of course, some people do experience long-lasting cures of their cancer.

Now I'm not suggesting that such cancers which are too advanced to be cured by conventional treatments could be cured by fasting alone, but the impression I get is that a combination of fasting and chemotherapy might make these conventional treatments more effective.

The research also implies there are a number of other benefits that result from regular or intermittent fasting, including increased longevity and a more effective immune system, which is the reason that I occasionally fast. The longest period I've fasted so far, drinking only water, is 4 days. 2 or 3 days is easy. Perhaps next time I might achieve 5 full days of fasting. 

Since I have the ability to fast without any excessive discomfort, I'm naturally interested in the possible benefits.

The source that you cite (at least the ones that I looked at) are not scientific at all. The fact that they cite various studies as "proof" of their claims does not in fact stand scrutiny as I said. Who, exactly, is the author of that article in CancerActive? No oncologist would have written that - an article like that would destroy his or her reputation irreparably. No, it seems that Mr A Nonymous wrote this article along with everything else on that website. So, whoever wrote this stuff has no idea how to evaluate scientific/medical research data and is actually writing to an agenda instead.

Tony, I quoted that link, CancerActive because it provides a general view that can be understood by the layperson. The organisation appears to be a Cancer Charity. This is how they describe their mission below.

"Our mission is to EMPOWER people to increase their personal odds of beating cancer; to be able to take more control over their own lives and their own treatment and to make more informed, personal choices about their cancer treatment options. We do this by providing ALL the information, not just on orthodox cancer treatments, but on complementary and integrative cancer therapies too. We aim to do this in an objective, balanced way and we take absolutely no money from any provider of any treatment."

Nowhere do I see them using the word 'proof'.

There are more scientifically oriented links amongst those below, for those who are interested.
Please feel free to tear them to shreds if you think they are all rubbish.
Here's an extract that seems rather positive to me, but no actual 'proof' of course.

FASTING AND CANCER

"Fasting has the potential for applications in both cancer prevention and treatment. Although no human data are available on the effect of IF or PF in cancer prevention, their effect on reducing IGF-1, insulin and glucose levels, and increasing IGFBP1 and ketone body levels could generate a protective environment that reduces DNA damage and carcinogenesis, while at the same time creating hostile conditions for tumor and pre-cancerous cells (Figure 5). In fact, elevated circulating IGF-1 is associated with increased risk of developing certain cancers (Chan et al., 2000; Giovannucci et al., 2000) and individuals with severe IGF-1deficiency caused by growth hormone receptor deficiency, rarely develop cancer (Guevara-Aguirre et al., 2011; Shevah and Laron, 2007; Steuerman et al., 2011). Furthermore, the serum from these IGF-1deficient subjects protected human epithelial cells from oxidative stress-induced DNA damage. Furthermore, once their DNA became damaged, cells were more likely to undergo programmed cell death (Guevara-Aguirre et al., 2011). Thus, fasting may protect from cancer by reducing cellular and DNA damage but also by enhancing the death of pre-cancerous cells.

In a preliminary study of 10 subjects with a variety of malignancies, the combination of chemotherapy with fasting resulted in a decrease in a range of self-reported common side effects caused by chemotherapy compared to the same subjects receiving chemotherapy while on a standard diet (Safdie et al., 2009). The effect of fasting on chemotherapy toxicity and cancer progression is now being tested in clinical trials in both Europe and the US (0S-08-9, 0S-10-3)."


http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3946160/
http://www.nature.com/onc/journal/v30/n30/abs/onc201191a.html
http://blogs.uoregon.edu/bi410/files/2014/04/mice-cr-1a727ci.pdf

[Tony Jay]

Ray can you see the excerpt that you are quoting is full of conditional language.
Words like 'potential', 'may', 'possible' dominate the language used.
This article is referencing legitimate research done at the level of the cell biologist using cell cultures of malignant cells.
And they found some very interesting things during that research.

They are now speculating that trying to reproduce a similar environment in a living organism may help.
This, however, is the untested part.
The hypothesis is attractive but it is still completely untested.
It appears that there is a plan to go ahead and institute several trials to test this hypothesis.

The whole tone of this is exactly what I would expect a responsible researcher to the in authoring an article for a peer-reviewed journal. No assumptions are made.

So, until the results of the various trials are published there will be no proof.

As for that site CancerActive it appears not to have a neutral approach at all but has a definite agenda.
They are marketing books on different issues - almost certainly these books promote what is known as 'alternative therapies'.
The reason why they are not 'mainstream' is for the very fact that there is no evidence to support what they are pushing.
However, there is a huge market of desperate people diagnosed with 'cancer' that has a poor prognosis who will try anything.
So this site functions like a marketing hub attracting people looking for 'safe' and 'non-toxic' therapies for their particular ailment.
Ultimately a lot of money changes hands.
Fad diets, shark cartilage, anti-oxidants...the list goes on and on.
I have seen all of this and more.
Much of this is harmless on one level - the 'safe' and 'non-toxic' therapies don't hurt but they actually do nothing.
On another level however the whole thing is very destructive - a lot of people waste a lot of money and time chasing a lie.
In addition false hope is generated that is dashed in the end.
Rob Campbell in a previous post mentioned the importance of hope, and it is important, but as stands is an incomplete statement.
It is not only the snake-oil salesman who are generating false hope.

I have had the regular experience of dealing with, usually, family members of a desperately sick oncology patient being emergently admitted to ICU, who frankly is dying with very little that any ICU could do to reverse the situation.
The difficulties arise because the oncologist has often been rather economical with the truth and so neither the patient nor the family are at all prepared for a situation that has been obvious to a clinician for some time (weeks to months).
Hiding the truth in these circumstances is actually immensely cruel because when the end comes no one is prepared for it.
You may think that I am just referring to the immediate emotional crisis that occurs in circumstances such as these but in fact far larger issues that need attention are not attended to.
Wills and legal matters are not attended to frequently leaving surviving family members in a severe legal and financial crisis.
Oftentimes major relationship issues are not addressed that would otherwise have been dealt with.
It is amazing how impending death focuses the mind and changes one's priorities.
Personally, I cannot adequately express my anger at some of my colleagues who consistently refuse to tell their patients the truth of their situation and hide behind the excuse that if they did then they would destroy hope in their patients.
As harsh as it may seem it is far far better to give patients and their families the truth and allow them to prepare in whatever ways they deem best.
Having been involved with these situations for more than twenty years I can absolutely confirm that it is possible to be open and honest with out being cruel. I lose count of the number of patients or family members who have thanked me for having the courage for telling them the truth. The truth enabled them to deal with the situation immeasurably better.
No one has ever come back to me and thanked me for hiding the truth from them (this did happen on a couple of occasions as a junior doctor when I was specifically instructed by much more senior colleagues to hide certain key facts from either the patient or the relatives - it was wrong then and it is wrong now - as a more senior doctor I would now never tolerate this).

In general the whole subject of 'cancer' is a highly charged and emotional topic with the general public.
Everyone has heard of horror stories related to either the disease itself or its treatment.
Sadly, many of these anecdotes do have more than a grain of truth to them.
As already stated in a previous post I would be the first to admit that medicine is unable to cure everyone with cancer, and, despite advances in both diagnosis and treatment of various cancers, survival rates are still not ideal.
In addition treatment may often cause problems that are worse than the disease being treated.

As a result there is huge pool of people across the world who would gladly embrace anything that is offered that allows them to avoid some of the horrors mentioned above.
Hence the huge industry of alternative therapy for cancer.
The problem is that they don't work (anecdotal evidence does not count).

I accept that aspects of diet are being investigated as having potential therapeutic benefit for some cancerous conditions.
No issues there.
However, reading the very words of the investigators themselves it is clear that no human trials have demonstrated benefit at this time.
This is in clear contradistinction to public health research (that include changes to diet) where there is evidence of preventative benefit.

My suggestion now is to let the subject lie.
I cannot dictate to anybody but I think, for me, that this topic has now been beaten to death.

Tony Jay

[Ray]

One thing that I think's worth adding to this discussion would be this: there's no limit to the value of continued hope. It may or may not cure or help anything physically - that's a separate issue - but it certainly does affect the quality of life of those affected by disease, whether as patient or relative.

Rob,
I think hope and faith are always a significant part of any treatment, whether the treatment is the application of orthodox medicine or alternative procedures. Even Jesus Christ understood that. 

Do you recall that account of a woman touching Christ's cloak from behind, causing him to turn around abruptly asking who touched him? Eventually a woman came forward and confessed it was her, but claimed she was cured (of whatever it was she was suffering from). Christ replied that it was her belief that had cured her.

This is known as the placebo effect, which is very real, as I'm sure even Tony Jay would admit. 

What surprised me recently was a report that there is even some beneficial placebo effect when the patient is told by the doctor that the pill he/she is receiving is in fact a placebo. One presumes that the compassionate act itself, of administering a pill, even when the patient knows it's just a sugar pill, can have a beneficial health effect.

This seems to be another area of medical science that is not fully understood.

[Ray]

Ray can you see the excerpt that you are quoting is full of conditional language.
Words like 'potential', 'may', 'possible' dominate the language used.

Absolutely! There's a great deal of uncertainty on so many health issues. It wasn't so long ago that all health institutes, such as the various Heart Foundations, were promoting the idea that all saturated fats were bad and that one should avoid full-cream milk, eggs and butter etc. if one wanted to reduce one's risk of a heart attack.

We now know that this is baloney. The body needs natural saturated fats, and struggles to produce its fat requirements from vegetable oils. Despite the massive proliferation of fat-reduced foods during the past several decades, heart disease has been on the increase.

Sure, virgin olive oil is fine, but so is coconut oil with its saturated fat. It's not just the level of LDL that presents a risk, but more significantly the balance between LDL and HDL. I'm glad we now understand that. Full-cream milk makes my coffee taste much better. 

They are now speculating that trying to reproduce a similar environment in a living organism may help.
This, however, is the untested part.
The hypothesis is attractive but it is still completely untested.

It's not completely untested. It's been tested on living organisms....such as mice and rats. Do you not believe in the theory of evolution, Tony? We share a surprisingly large amount of DNA sequencing with other living organisms.

Fad diets, shark cartilage, anti-oxidants...the list goes on and on.
I have seen all of this and more.
Much of this is harmless on one level - the 'safe' and 'non-toxic' therapies don't hurt but they actually do nothing.
On another level however the whole thing is very destructive - a lot of people waste a lot of money and time chasing a lie.
In addition false hope is generated that is dashed in the end.
Rob Campbell in a previous post mentioned the importance of hope, and it is important, but as stands is an incomplete statement.
It is not only the snake-oil salesman who are generating false hope.

Oops! So I was wrong when I stated in my previous post that even Tony Jay would accept the reality of the placebo effect. 

I agree that spending money on a pure placebo would not be as effective as spending the same amount of money on a tested drug that has proven to be more effective than a placebo. However, if the placebo costs nothing, and actually costs less than nothing, as fasting does (because one spends less on food), then that has to be worth something, surely. 

If the fasting is more than a mere placebo, as I suspect it is, then Wow! Get my point? 

[degrub]

Hi Ray,

Cells, mice, and rats are models that we experiment with because they provide indications of what treatment might work in humans. The theory still has to be tested in humans for safety, efficacy, dose, and unintended effects. A model is just that  - it is never correct, but it can be useful. So the fact that there is partial shared genetic heritage makes them a useful tool for filtering what might work in humans. Human trials with enough participants to allow affirmation with acceptable statistical significance are still required to establish causation rather than correlation.

The past theories about diet and impacts on cardiac health were just that although they have been promoted as cures. The models were not complete because of partial understanding and thus inaccurate in hindsight. Did they produce useful results - certainly in some cases. But we understand more today and realize it is not that simple or even not substantiated. We will understand more in the future.

The placebo effect depends  on the belief in the treatment. The mind can certainly influence the outcome of a treatment. The treatment still requires evaluation against randomized, double blind human trials to be accepted as causative.

[Ray]

The treatment still requires evaluation against randomized, double blind human trials to be accepted as causative.

Hi,
Of course it does. However, because of the huge variation in human activities, life-styles, eating habits, exercise, mental attitudes of worries and concerns, placebo effects resulting from so many things and situations, not to mention the obvious variations in individual genetic make-up resulting in certain weaknesses and strengths, and so on, it becomes very difficult to be certain about the effects of long-term treatments, of which fasting is an example, because of the difficulty of  putting a significant number of humans in a strictly controlled environment for a significant period of time.

Drugs tend to have a more rapid and immediate effect, which makes testing easier. Dietary effects can take much longer. Ask yourself, how it was possible for the medical establishment to get the saturated-fat issue so wrong. It wasn't because no scientific studies were undertaken. It was at least partly because of the difficulty in effectively conducting controlled experiments with humans.

You might be surprised to learn that about 92% of our genes (or DNA encoding) is similar to those of mice.

Ultimately, we are all conditioned by our own experiences, and influenced by our general understanding of various treatments  and what's involved. Fasting, whether voluntary for religious reasons, or involuntary as a result of drought and general shortage of food, has been a part of human history, and the history of our distant ancestors, for millions of years. My understanding is, the body has adapted well to such regularly occurring circumstances during the course of evolution.

The explanation for the efficacy of fasting in fixing emerging problems in the body, makes sense to me. When the body is freed from the chores of digesting new food inputs, and breaking down that food into the various compounds that the system needs, the body's natural processes are more able to attend to any emerging problems.

However, I do understand that fasting is not appropriate for everyone, without consideration of individual circumstances. An anorexic or underweight person, or a pregnant woman should definitely avoid fasting, and I imagine that there are a number of people who are reliant upon medication that is required to be taken with food.

[Rob C]

It's never a clear-cut situation, though, and in my wife's case especially so (or so I believe, basing that opinion on a close experience of but two sufferers): she eventually had five cancer ops, and prior to each one she was of normal weight. Immediately after each intervention she turned into a living skeleton within a day or two. I know, because in Spain, in private hospitals, a relative can share a room with the patient and does, in fact, help out where that's within his/her knowledge of what to do. I think the relative's presence does a lot of good, psychological things for the patient, quite apart from what it can do for the relative's own mind and mental growth. So anyway, at that post-op stage, fasting would have been a negative input. But that's not to say that at other stages in life it can't be a positive.

However, isn't it always like that in life? We do what we think best at the time, but the final results of such actions - or lack of them - are way beyond out intentions, control or probably even expectations.

But there's still one scenario that's worse: immortality of a human body unless the ravages of age and the biological clock can be halted along with the time clock. I see all too clearly my own slow disintegration; I hate to imagine what it would look like in another fifty years of the same 'progress'!

Rob C

[Otto Phocus]

I think this is an issue of confusing correlation with causality.

It may be possible to find 10/100/1000/xxx people who were diagnosed with some form of cancer (which is often more complicated than often thought) and when they fasted, there was a change in the cancer... perhaps even where they were cured of cancer.  That's correlation.   People who did A had B as a result.

But as some dead Latin guys liked to say: Cum Hoc, Ergo Propter Hoc which roughly translates as "with this, therefore because of this".  It is a logical fallacy.

Because there was a observation that there was a change in a patient's cancer while they were fasting, does not indicate that the fasting caused the change in cancer.

Correlations may indicate potential causality, but causality must be independently tested.

It is my understanding that the causality relationship between fasting and effects on cancer have not been demonstrated.

[Tony Jay]

I think this is an issue of confusing correlation with causality.

It may be possible to find 10/100/1000/xxx people who were diagnosed with some form of cancer (which is often more complicated than often thought) and when they fasted, there was a change in the cancer... perhaps even where they were cured of cancer.  That's correlation.   People who did A had B as a result.

But as some dead Latin guys liked to say: Cum Hoc, Ergo Propter Hoc which roughly translates as "with this, therefore because of this".  It is a logical fallacy.

Because there was a observation that there was a change in a patient's cancer while they were fasting, does not indicate that the fasting caused the change in cancer.

Correlations may indicate potential causality, but causality must be independently tested.

It is my understanding that the causality relationship between fasting and effects on cancer have not been demonstrated.

You are absolutely correct that correlation does not equal causality.
However in the context that we are debating even when causality has been established in studies done with cell cultures or even animal studies this does not imply in any way that a similar intervention in humans will have the desired effect.

I have been involved in several studies looking at certain pharmacological interventions (not antibiotics) aimed at short-circuiting the inflammatory response in septic shock. In every case the animal studies were exceptionally promising with remarkable results obtained.
In every case however the same interventions in human trials were a dismal failure.
In some trials mortality actually increased in the intervention arm.

From my perspective (as an actual clinician) until human trials show that an intervention works all the other research is interesting and piques the curiosity but, from a clinical perspective, ultimately unhelpful.
Obviously, as far as novel therapies are concerned, for the research to advance to the point of human trials all of the basic science and animal trials are absolutely necessary.

However, I cannot get excited about any of the research I have seen regarding diet as a therapy for malignancy at this point in time.
If, however, any human trials show benefit then that would would be worth looking at.
Until that time...

Tony Jay

[Ray]

You are absolutely correct that correlation does not equal causality.

And I am also in complete agreement on this point. The differences between correlation and causality are a major issue in Climate Change, for example. Those who are skeptical about the significance of rising CO2 levels as a cause of global warming point out that paleoclimatology studies often reveal that rising CO2 levels seem to have followed periods of global warming in the past, rather than precede it, and therefore cannot be the cause.

However in the context that we are debating even when causality has been established in studies done with cell cultures or even animal studies this does not imply in any way that a similar intervention in humans will have the desired effect.

That seems a very odd statement, Tony. If the results of animal studies does not imply in any way that a similar intervention in humans will have the desired effect, why are we wasting time and money carrying out tests on animals? 

I have been involved in several studies looking at certain pharmacological interventions (not antibiotics) aimed at short-circuiting the inflammatory response in septic shock. In every case the animal studies were exceptionally promising with remarkable results obtained.
In every case however the same interventions in human trials were a dismal failure.
In some trials mortality actually increased in the intervention arm.

That result in itself should be the subject of a further study to determine why a particular procedure has been effective with certain animals but not humans. Even among humans, the same procedures and the same drugs are not always equally effective, and can sometimes even make a condition worse as a result of a particular allergy that an individual might have.

However, I get the general impression that the same medicines, including most antibiotics, anti-anxiety medications and pain-killers that are effective on humans are also effective on dogs, cats, horses, sheep and so on, although the dosages might be different.

From my perspective (as an actual clinician) until human trials show that an intervention works all the other research is interesting and piques the curiosity but, from a clinical perspective, ultimately unhelpful.
Obviously, as far as novel therapies are concerned, for the research to advance to the point of human trials all of the basic science and animal trials are absolutely necessary.

That seems reasonable, but in contradiction to your previous statement above. 

However, I cannot get excited about any of the research I have seen regarding diet as a therapy for malignancy at this point in time.
If, however, any human trials show benefit then that would would be worth looking at.
Until that time...

As a doctor you are obliged to recommend and administer only treatments that have been officially approved by the FDA or TGA. I understand that. As a doctor you are not a dietician. That's not your speciality.

However, as an individual who is prepared to take responsibility for his own health and use his nous, it's clear to me that an ideal diet in conjunction with physical exercise are the key ingredients for a healthy and long life. If it were possible to ensure that everyone ate a healthy and wholesome diet and exercised regularly, in between occasional periods of fasting, (which isn't possible of course), there would eventually be massive redundancies among hospital staff and GPs, and a huge saving of money. 

[Rob C]

"However, as an individual who is prepared to take responsibility for his own health and use his nous, it's clear to me that an ideal diet in conjunction with physical exercise are the key ingredients for a healthy and long life. If it were possible to ensure that everyone ate a healthy and wholesome diet and exercised regularly, in between occasional periods of fasting, (which isn't possible of course), there would eventually be massive redundancies among hospital staff and GPs, and a huge saving of money.  "

And so much over-population that we'd be falling off the surface of this little planet or, alternatively, have induced so much gravity as to produce our own black hole and implode.

;-)

Rob C

[Ray]

"However, as an individual who is prepared to take responsibility for his own health and use his nous, it's clear to me that an ideal diet in conjunction with physical exercise are the key ingredients for a healthy and long life. If it were possible to ensure that everyone ate a healthy and wholesome diet and exercised regularly, in between occasional periods of fasting, (which isn't possible of course), there would eventually be massive redundancies among hospital staff and GPs, and a huge saving of money.  "

And so much over-population that we'd be falling off the surface of this little planet or, alternatively, have induced so much gravity as to produce our own black hole and implode.

;-)

Rob C

Why? I can't see the connection. Are you implying that access to nutritious food and access to education about what constitutes nutritious food and the types of exercise that are beneficial for good health, would result in people having more children?

Oh! I see what you mean. If everyone were to have the same number of children but everyone lived longer due to better health, then there would be an increase in the population of elderly people. However, it's well known that part of the motivation to have large families is the insecurity that people imagine they will feel as they get older without a social security network or the means to pay medical bills. Family support is more important in those situations of poverty.

A world in which everyone was educated about nutritious diets, which can actually cost less than processed food and result in less medical expenses, would be a more secure world resulting in a lower population growth. 

[Slobodan Blagojevic]

Why? I can't see the connection. Are you implying that access to nutritious food and access to education about what constitutes nutritious food and the types of exercise that are beneficial for good health, would result in people having more children?

Population growth is a net effect between natality (i.e., "people having more children") and mortality. Reduce mortality, and you'd have population growth without necessarily the same number of people having more children.

[Rob C]

Why? I can't see the connection. Are you implying that access to nutritious food and access to education about what constitutes nutritious food and the types of exercise that are beneficial for good health, would result in people having more children?

Can you doubt it?

(I know you're joking.)

;-)

Rob

[Ray]

Population growth is a net effect between natality (i.e., "people having more children") and mortality. Reduce mortality, and you'd have population growth without necessarily the same number of people having more children.

I've edited my post above. If people don't have more children, say 2 on average, then the population will increase initially as the percentage of elderly people increases, then stabilize after no further increase in longevity. If people have fewer children as a result of increased security, then the population will decrease.

The major advantage of a healthy lifestyle is not so much an increase in longevity, but a healthier and more active life whilst one is in those later stages of life when the effects of overeating tasty, junk food and being too lazy to exercise take their toll. Drugs and medical procedures do a fairly good job at keeping people alive despite their being very unhealthy.

[Slobodan Blagojevic]

Healthier people in good shape, not dying young, are more likely to mate, hence the population growth

[Rob C]

Healthier people in good shape, not dying young, are more likely to mate, hence the population growth

Slobodan, you surprise me!

Having sex when older is great fun, as having children becomes an impossibility. Thank God.

;-)

Rob

P.S.

LuLa ¡s becoming a minefield of well-intended, poor advice! Whoda thunk?