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