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?LIVING PROOF?
By Michael Gearin-Tosh
Simon & Schuster, Inc. U.K. Ltd.
ISBN 07432-0677-0

An inspiring new book written by a myeloma patient has just been published in Britain. Michael Gearin-Tosh, a teacher of Theatre Arts at Oxford University, was diagnosed with IgG multiple myeloma in June 1994 at age 54 years. Now, almost 8 years after diagnosis, Michael is doing well overall having taken no chemotherapy treatment for his disease. This medical mutiny, as he calls it, is a story which is both powerful and thought-provoking. The mainstay of his treatment has been the Gerson Therapy*, a nutritional approach with some modifications and additions. ?Living Proof? is a testament to the fact that ?here he is,? having been told, as he says in the book?s opening, that he would be ?a goner.?

With encouragement and support from friends, plus consultations around the world, Gearin-Tosh analyzed the medical advice that he received. His conclusions are very sobering for the medical profession. Do we really know what we are doing? Did he really have active myeloma which required transplantation and/or chemotherapy recommended by top consultants? If he did not have active myeloma, why the confusion? And what about other patients who may not be as insightful and persistent in their search for the true answers to the many concerns and questions?

His case history summarizes early stage disease, classified as Stage IA: the IgG monoclonal protein has ranged from 3.1 Gms% to a high of 4.53 Gms%, most recently being 3.54 Gms%. These numbers are right at the cutoff between MGUS and myeloma. The bone marrow tests have never shown a high percentage of plasma cells: ranging from 5-6% to a high of 22%. Anemia has been the persistent problem, supporting the diagnosis of myeloma versus MGUS with hemoglobin levels in the 9-10 Gms% range. Bone x-rays and bone density testing have indicated osteopenia (osteoporosis), but no discrete myeloma lesions. Serum b2 microglobulin and CRP levels have been low.

Conclusion: the findings are consistent with a low level non-aggressive type of myeloma, which can have a variable, but sometimes very long, natural history including survival of at least 8 years.

Is this type of longer survival predictable? Unfortunately, not in a definitive fashion for an individual patient. However, as mentioned in one of the later chapters, some tests such as a labeling index can predict disease activity. Initial emphasis was on finding ?the cure,? which Gearin-Tosh finally discovered was like locating the end of a rainbow ? maybe close, but not yet accessible. Bravely, he set recommended options aside and followed his intuition to the Gerson Therapy, additional orthomolecular oncology and enzymes, plus acupuncture and ?mind over matter? visualization and breathing exercises. It is extremely important to note two additional points. Firstly, he did take Clodronate initially, followed more recently by Ibandronate (both bisphosphonates which can help bones and myeloma overall). Secondly, he has taken a variety of ?anti-inflammatory? medications which can suppress myeloma activity. In animal model systems, anti-inflammatory medications can be sufficient to suppress myeloma growth. Is Gearin-Tosh doing well because of these treatments? Maybe, maybe not. It is impossible to dissect the role of the various interventions, including the Gerson Therapy. Certainly his indomitable spirit and positive commitment to recovery are key elements.

Of interest, Gearin-Tosh used Vitamin C at very high doses and has done well with it. This is not normally recommended in myeloma patients in part because of kidney toxicity.

What does all this say about the medical profession? We need to do a better job delineating and communicating areas of medical uncertainty, especially when aggressive therapy is involved. With low-level disease, a non-aggressive approach can be perfectly acceptable. On the downside of accepting milder treatment is the acknowledgement of ?not going for the cure.?

Gearin-Tosh highlights the conflicts and emotions dealing with physicians, friends, and literary insights as he selects his course to become ?Living Proof? of his own successful choices. It takes a rare personal confidence to fully trust one?s instincts. As physicians, we need to support such individual decisions provided they are not ?medically crazy.? Was Michael crazy to take his life in his own hands? Perhaps some physicians thought so, but the proof is always in the end result. Thank you, Michael, for writing your story and so eloquently discussing your life and the impact of decisions and recommendations that physicians make. You are the ?Living Proof? that we don?t have all the answers.

* For more information about the Gerson Therapy, visit www.gerson.org or call (888) 4-GERSON.