Mayo Clinic, Rochester Minnesota
It is easy to understand why a person diagnosed with a malignant
disease would seek out unorthodox therapies. Many patients with cancer
will reach the point at which proven therapy is not very effective. In
this situation most physicians will offer pain control and nutritional
supplementation for its palliative benefit. Fueled by the current
epidemic of HIV, the number of unconventional therapies is on the
Studies have demonstrated that patients most likely to seek out
unorthodox therapies have a higher education level and a higher median
income. These patients tend to be sophisticated and capable of
searching out unconventional modalities. The typical psychological
profile of these patients is:
- higher socioeconomic status;
- "in charge" all of their lives;
- active role in medical management.
Frequently a physician's management plan is so complex and high in
technology that it is difficult to understand by most individuals.
Patients wish to be active participants in their care and to help out
in any way they can. Although participation is a very positive
motivation, it may not be realistic in light of the known biology of
malignancy. Many unscrupulous practitioners are able to take advantage
of this mind set. Most unconventional therapies offer easy to
understand treatments that have a "logical" rationale. Most
of these will also allow for active participation by the patient and
often carry the logo "holistic".
Mental imagery is one such technique. Patients are instructed to
draw a mental picture of their underlying tumor and then recruit
"all" parts of the immune system, particularly the white
blood cells to attack and thereby destroy the tumor. This technique
allows the patient to participate and is easy for the patient to
understand even though the mechanism is unrealistic. The unscrupulous
practitioner will also supply a large body of unsubstantiated data
that would suggest mental imagery can be channeled into the
destruction of a tumor. No data exists that this is an effective
technique. The technique is valuable in that it emphasizes a positive
attitude and a good outlook, but this does not translate into tumor
Nutrition is a very important aspect of unconventional therapies.
Anti-cancer diets are heavily promoted. These diets by and large tend
to be healthful in that they are low in saturated fats, high in fiber
and naturally occurring vitamins. However, there are those that are
highly restrictive and may constitute simply barley or rice and water
which can result in extreme degrees of weight loss which is generally
not to the patient's best advantage. Even when a patient consumes a
healthful diet, there is no evidence this is effective in treating
cancer. As much as we would like a diet to be effective in the
treatment of cancer, there is no evidence that dietary manipulation
can result in the regression of an established malignancy. It is
generally good for all people in all age groups to eat a healthful
diet, but extremes need to be avoided. Many fraudulent cancer
practices involve magical thinking. One such notion is that the bowel
contains many toxic substances and poisons. This hypothesis justifies
the use of enemas and purgatives to detoxify poisonous substances in
the bowel, removing them from the system. This has led to the use of
coffee enemas and irrigations to purge the bowel. Patients frequently
have a magical notion about the role of vitamins in human nutrition.
Vitamins are known to be coenzymes that help catalyze biochemical
reactions. Nonetheless people view vitamins as "pick me
ups", "energizers" and general "feel good"
pills. People take iron regularly for anemia, whether anemia is
related to iron deficiency or not.
Unscrupulous practitioners are becoming increasingly sophisticated
in their presentation of fraudulent therapies to the public at large.
Cell specific cancer therapy in Santa Domingo, Dominican Republic, has
recently been promoted in a number of underground magazines as a new
treatment for cancer. Fundamentally, this is a technique where magnets
are used to attack the malignancy. The presentation is in a very
polished brochure, seems very logical, but a review of the National
Library of Medicine database reveals no citations for this technique
and with no peer-reviewed confirmation this technique must be
considered unproven and highly likely to be fraudulent. A second
technique that has recently come to our attention is gene activation
therapy using auto-transfusion with patient's own white blood cells,
also known as tumor-specific cytokines in cancer therapy. This title
alone indicates a high level of sophistication. This technique is
currently being administered by a practitioner in Memphis who is not a
member of the American Society of Clinical Oncology or the American
Society of Hematology. Reportedly, the patient's blood cells are sent
to Germany for cytokine activation and are subsequently returned to
the patient to boost the immune system. No IND exists for this process
with the FDA. I am unable to confirm a registered protocol with the
National Cancer Institute, nor can I confirm that there is an
institutional review board involved confirming this as a research
protocol. On review of the pamphlets they provide, they have many
testimonials to the effectiveness of the technique. Moreover, the
mechanism of action is very, very logical and would easily seduce the
unwary as to its effectiveness. Nonetheless, this technique does not
appear to be applied by reputable researchers in scientific medical
centers and, therefore, must be considered unproven. I have come
across many other similar unproven techniques that are offered to
desperate cancer patients, but they all seem to have similar common
facets such as a scientific explanation that does not hold up, proof
via testimonials, and no peer-reviewed scientific articles.
One of the drawbacks of cancer therapy that involves the patient's
participation is the inevitable psychological result if treatment
fails. A common scenario for patients whose malignant disease
progresses following fraudulent treatment is:
- they came too late for treatment and if only they had come
- they didn't have sufficient faith in the technique to make it
work and, therefore, the fact that their cancer has progressed is
- the technique was not followed properly in accord with the
recommendations of the fraudulent practitioner and, therefore
progression is the patient's responsibility once again.
This results in a tremendous burden for the patient. Not only do
they have to cope with the fact that they have a malignancy, but they
have the added burden that it is their fault.
Fraudulent medical practice dates back to antiquity and it is
unlikely that any law, regulatory agency or congressional panel will
ever eradicate fraudulent therapies promoted to desperate individuals.
Adequate communication between an experienced physician and the
patient can uncover notions that the patient might have in seeking
unconventional therapy. Since, in the treatment of cancer, there are
frequently situations where no effective treatment exists, all we can
often give is our time. Effective communications between the cancer
patient and his or her physician is the best treatment to prevent
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