I regularly attend the annual meetings of both the American Society of Clinical Oncology (ASCO) and the Cancer Control Society (CCS). Both are venerable institutions – ASCO now in its 40th year, CCS in its 32nd. Both events attract numerous participants to major venues – ASCO 2004 had a record 28,000 attendees while the much smaller CCS 2004 had 1,200 this year. Each meeting featured numerous presentations on the latest developments in cancer prevention and treatment, with informative displays from companies involved in the field. But there the similarities end. In fact, the two events are so divergent that, like Klingons and Kardassians, they seem to hail from different quadrants of the Galaxy.

For over three decades, under the leadership of Ms. Lorraine Rosenthal and her colleagues, the CCS has been a source of hard-to-find information on alternative treatments. Its annual convention has functioned as a showcase for many new ideas in the CAM approach to cancer. I have spoken at the CCS meetings several times since 1980.

CCS 2004 featured about 50 lectures on various topics of immediate interest to patients, including the use of vitamins, minerals, antioxidants and herbs against cancer. There were quite a few presentations concerning environmental hazards. Dr. Doris Rapp and Burton Goldberg gave impassioned pleas for environmental sanity.

A few of the presentations might conceivably have bridged the two worlds. Patrick Quillen, PhD, gave an enlightening presentation on nutritional support during cancer treatment. Lance Morris, NMD, spoke about hyaluronic acid, vitamin C and cancer, a subject that was also addressed at the 2003 ASCO meeting (Abstract #3023). But there were also talks on concepts that would be unknown to most ASCO participants – "prolotherapy," "diabesity," "vitamin L," etc. By and large, the topics discussed at the two meetings rarely overlap.

South of the Border
The CCS meeting provided insights into the cancer clinics south of the border. There were speeches by clinic directors, booths manned by clinic personnel, and (a few days later) a bus tour of the most prominent clinics, hosted by CCS vice-president Frank Coustineau.

On each of the days of the CCS meeting there were about two dozen presentations. The clinic spokespersons included Charlotte Gerson, founder of the Gerson Institute, who spoke about the work of Baja Nutricare; Bill Fry and Geronimo Rubio, MD, presenting the protocols of the American Metabolic Institute; Francisco Contreras, MD, who reminisced about 41 years of metabolic therapy at the Oasis of Hope Hospital; Kurt Donsbach, DC, who spoke about his work at the Santa Monica Hospital; Gilberto Alvarez, MD of the Stella Maris facility in Tijuana – and that was all on the first day!

On the second day Mike Culbert and Rodrigo Rodriquez, MD, spoke about complementary therapies at International BioCare and on Monday, Ferre Akbarpour, MD, spoke about her work at the Orange County Immune Institute in Huntington Beach, California, one of the few U.S. clinics represented. Les Breitman, MD spoke about Insulin Potentiation Therapy (IPT), a treatment that is also given at an outpatient facility in Tijuana. The oldest-established Mexican clinic, the Bio-Medical Center, was not represented, but there were a number of presentations on the Hoxsey herbal method practiced there.

New Ideas
Laetrile–still the bête noir of ASCO-oriented oncologists–was favorably covered, as it has been at most earlier CCS meetings. But there were also interesting presentations on Chinese medicine. Tsu-Tsair Chi, NMD, spoke on the use of Chinese herbs for cancer. There was also a speech on the Tien Hsien herbal liquid and displays on electroacupuncture as well as Chinese pulse diagnosis.

Perhaps the most controversial presentations on this year's agenda were those dealing with the compound Poly-MVA, several of which cast the palladium-containing compound as a seemingly miraculous treatment for cancer. Tony Martinez, MD, of the "Hope4Cancer" clinic gave an impassioned talk on his work with Poly-MVA. He showed slides of a huge melanoma of the foot of one of his current patients. A few days later, in Tijuana, I had the pleasure of meeting the individual attached to that foot. In his hometown he had been presented with radical amputation as his sole treatment choice – but opted instead for unorthodox medical treatment in Mexico. According to both patient and doctor, the tumor had already diminished in size since the patient began treatment just a week earlier. It will be interesting to follow this gentleman's case.

Shortage of Good Ideas
On the whole, it is a pity that more people who are seriously interested in the treatment of cancer do not attend both the ASCO and CCS meetings. Each group has something to offer the other. The orthodox ASCO is very strong in its methodology for testing new treatments. Working in concert with the mainstream medical establishment, ASCO has refined a way of determining whether or not a particular approach is really effective (i.e., a series of standardized tests culminating in a randomized controlled trial).

Yet what is missing at ASCO is an openness to new ways of fighting cancer. There is an over-emphasis on finding patentable and profitable pharmaceuticals, rather than encouraging a free play of ideas and following wherever the data itself leads. Given this increasingly narrow view, it is no wonder that a leader of the field, Bruce Johnson, MD, of Dana-Farber Cancer Institute, Boston, told a reporter, "We have a shortage of good ideas" (Leaf 2004). A savvy Wall Street Journal observer wrote that the so-called targeted therapies, the current jewel in conventional oncology's crown, have not lived up to their promise. "For the majority of patients, targeted therapies have been a disappointment," Leonard Saltz, MD, of Memorial Sloan-Kettering Cancer Center, New York told her. "The word 'breakthrough' just doesn't fit" (Begley 2004).

CCS is very strong in the New Ideas department. Many of these ideas originated in conventional medicine but were then dropped because they were in the public domain. There are enough interesting therapeutic ideas at CCS to fuel scientific studies for many years. What CCS doesn't have is any agreed-upon methodology to judge the validity of the concepts that are presented at its meetings. While naive trust in anecdotal evidence was rightly banished from conventional medicine more than 50 years ago, many in the alternative medicine community still seem willing to accept undocumented anecdotes as proof of the safety and effectiveness of new treatments. This can lead to exaggerated claims.

Freedom of Choice
ASCO leaders often downplay the important role that patient initiative and freedom of choice have had in successfully fighting cancer. It is the patient who should be the primary decision maker; the doctor is simply there to help. Yet doctors often get that fundamental definition of roles backwards. An oncologist at ASCO 2004 characterized patients who wanted to receive CAM treatments as suffering from a "psychopathology." No one challenged him. Of course freedom of choice is not a psychopathology, but a fundamental medico-legal principle. The fact that some oncologists deeply resent this principle puts them at odds with the best interests of their patients and frequently leads to acrimonious conflicts.

CCS, on the other hand, is unwavering in its support of freedom of choice. But sometimes this can become a shibboleth which obscures the lack of scientific justification for various treatments. It can even spill over into bizarre displays of jingoism. One CCS speaker regularly appears in a towering Uncle Sam hat. Another speaker, after the Pledge of Allegiance, insisted that audience members stand and join him in singing 'God Bless America,' complete with a war whoop at the end. One longs for more documentation and fewer demonstrations of political rectitude. As they say around the National Institutes of Health, "In God we trust. All others show data."

Derogatory Comments
Not surprisingly, at ASCO one frequently hears derogatory comments about alternative treatments in general. But such comments are very often seriously ill-informed. Few oncologists realize, for instance, that Frederick Mohs, pioneer of the microsurgical technique that bears his name, at one time used an external paste in conjunction with his microsurgical technique that was similar to the escharotic paste used by the 'quack' Hoxsey. There is frequently a defensive knee-jerk reaction to the topic of CAM among oncologists, preventing any nuanced discussion. Similarly, one hesitates to even whisper a kind word about conventional therapy at CCS, where orthodox medicine's approach is branded "cut, burn and poison."

Humanitarian Award
I was honored to receive CCS's Humanitarian Award. It was a particular honor to receive an award some of whose earlier recipients were Stanislaw R. Burzynski, MD, PhD, Prof. Samuel S. Epstein, MD, Josef M. Issels, MD, and O. Carl Simonton, MD.

The Award Citation reads as follows: "For over 30 years, you have fought for the fair testing of Complementary and Alternative cancer therapies. In the 1970s, you lost your position at the Memorial Sloan-Kettering Cancer Center, when you exposed the cover-up of positive experiments with Laetrile (amygdalin).

"Your 11 books, such as The Cancer Industry, Herbs Against Cancer, and Questioning Chemotherapy are beacons of light for thousands of cancer patients and practitioners. You were instrumental in helping to create the National Center for Complementary and Alternative Medicine at the National Institutes of Health. Because of your efforts, these therapies have now become a respected branch of medicine.

"You have tirelessly advised and counseled thousands of cancer patients. For the past 10 years you have researched and written The Moss Reports, which inform patients of their options in over 200 types of cancers. Your weekly Moss Report newsletter has gone out to tens of thousands of cancer patients and families.

"You were among the first to grasp the potential of the Internet and in 1997 you wrote the book Alternative Medicine Online. Your cancerdecisions.com website is now the #1 rated site for the topic 'alternative cancer treatments' in Yahoo!

"You are the conscience of the cancer community and we hereby acknowledge your achievements as an investigative journalist, a passionate voice for patients' rights and a crusader for the truth!"

Feeling the need for balance, I decided to use part of my acceptance speech to say a few favorable things about conventional treatment. This is a message not often heard from the podium at CCS meetings. For instance, I warned patients in no uncertain terms about the life-threatening danger of delaying curative conventional treatments in favor of untested alternatives. I also spoke about the real (albeit often exaggerated) menace posed by frauds in the CAM field. Judging by the applause, I think this message was appreciated by most in the audience.

Conversely, if I am ever invited to speak at ASCO I will try to explain the benefits to be derived from a serious and open-minded consideration of alternative approaches to cancer, including many of those presented at the CCS meeting.

On a personal level, it is enormously gratifying to receive such honors, however, I see them also as an endorsement of the particular approach to alternative treatments that I have taken over the years. Back in 1977, I wrote the following about the Laetrile controversy: "Our interest in Laetrile has always been to have it adequately tested and to have all those research results released. . . . The focus of the Laetrile movement should be to mobilize large numbers of people to demand the truth from the scientific establishment about this agent, and all issues related to cancer." Over the years, I have put my emphasis on fostering the fair scientific evaluation of the various methods that are used in the treatment of cancer, from surgery to alternative treatments coming from outside the mainstream. A belief in the value of good science is the underlying principle of all that I write and do. I seek the cooperation of all likeminded people who want to see CAM subjected to intensive but even-handed scrutiny.

A lot of people talk glibly these days about "integrative oncology." But it remains more a dream than a reality. What is needed is a true integration of the two sides of the field, rather than what we have now, a standoff of galactic proportions. So who knows? Maybe Klingons and Kardassians will one day lay down their deadly knives and battleaxes and make peace. And maybe ASCO and CCS will realize that instead of fighting each other they should unite in fighting their common enemy, cancer.

Resources
The program of the 32nd Annual Cancer Convention is available at: http://www.cancercontrolsociety.com/program2004.htm

The CCS speeches (including my own) are available in VHS videotape for $15 apiece from Chuck Wintner/ Malibu Video, phone: 818-775–3923, E-mail: cfwintner@aol.com

Begley, Sharon. Why targeted drugs to battle cancer fall short of promise. Wall St. Journal, Science Journal, Sept. 10, 2004, page B1.