APPENDIX A (APPENDIX B »)
Choice in Resources
Writing this discussion of resources for cancer patients has been one of the most difficult tasks I have faced. The reasons for these difficulties are instructive, and worth considering at the outset.
The easiest resources for me to describe are those that simply provide information. Whether or not I agree with the bias of the information source, I can describe and assess the kind of information you will get.
The hardest resources to describe are those that identify specific sources of conventional or unconventional cancer treatments.
Why is this? Consider mainstream treatment first.
We can (and do) list the Comprehensive Cancer Centers selected by the National Cancer Institute. But while the latest technology and treatments are provided in these centers, many other hospitals offer treatments for most cancers that are equally good, and the human side of the treatment may be decidedly better than in some of the Comprehensive Cancer Centers.
Identifying the best practitioners is even more difficult. We certainly know many oncologists, radiotherapists, surgeons, psychiatrists, and psychologists across the country who have been highly recommended by patients. But many of the best mainstream practitioners do not want to be listed in a resource guide. They are known by word of mouth and by professional referrals. Their practices are already overflowing. And a lovely, if endangered, ethic still holds sway in some medical circles that self-advertisement does not fall within the great traditions of medicine or healing.
Even if we choose to disregard the preference of these practitioners not to be listed, other difficulties remain. First, we know only a tiny fraction of the good practitioners in the United States and abroad. Listing the one we know but not the hundred we do not know is unfair. Second, when good practitioners grow too busy, the quality of their service drops–often dramatically. Third, and most important, is the whole question of what a “good” practitioner is. Setting aside the issue of incompetence, one could evaluate a practitioner in terms of technical skills, humanistic qualities, and preferences for different “styles of risk” in therapy (e.g., does the oncologist prefer an aggressive or conservative approach to treatment?). Ultimately, what makes for a good “fit” between patient and practitioner encompasses technical, humanistic, and stylistic factors that cannot be summarized in an abstract formulation. Simply put, the oncologist who is good for one patient may be wrong for another.
For all of these reasons, I have chosen not to list mainstream physicians and other practitioners. In chapter 6, I described how to find the practitioners that will work best with you: Ask other cancer patients; ask other physicians who work with these doctors; ask nurses who work closely with surgeons, radiation therapists, and oncologists in hospitals and can compare them.
Now, let us consider the problems involved in describing resources in unconventional or complementary cancer therapies.
All the problems involved in deciding whether to identify specific mainstream hospitals and doctors remain problems for some unconventional centers and practitioners: well-known centers are by no means necessarily the best; many of the best practitioners do not want to be listed because their practices are already full; those that become too busy often provide lower-quality services; and the problem of “fit” between patient and practitioner remains.
Nonetheless, while it is not common practice in mainstream medicine to list preferred individual practitioners, it is common practice in the literature on unconventional treatments to list individual practitioners as resources. Here another set of problems emerge. The “pro-alternative therapy” publications provide glowing reports of these practitioners and their centers; the “anti- alternative therapy” publications condemn them. In the chapters on individual practitioners in this book, you have seen how difficult it is to evaluate fairly even a handful of the most interesting practitioners, if one moves beyond the “true believer” position. So my dilemma has been acute.
For all these reasons, I urge caution in using this resource section, particularly with respect to the unconventional cancer treatments. I describe resources as best I can. Evaluating them is up to you and your physician and those whose judgment you trust.
Information Sources for Mainstream and Complementary Therapies
National Cancer Institute
Hot line: 1-800-4-CANCER
The National Cancer Institute (NCI) publishes a wide range of useful pamphlets and brochures on many types of cancer and cancer treatments. The NCI hot line can give you a great deal of specific information on different types of cancer treatments–both mainstream and complementary–research programs, and treatment institutions. The information on mainstream treatment is usually excellent. The information on unconventional treatments is usually a rehash of information from the American Cancer Society’s “unproven treatments” list. This can be a useful starting point for your researching an unconventional therapy, provided you understand the strong skepticism of the NCI about these therapies.
American Cancer Society (ACS)
The American Cancer Society (ACS) is a significant resource. You should distinguish between the central office and the local chapters around the country. The central office is criticized by some practitoners of mainstream cancer therapy for its particular biases in funding cancer research. It is also vilified by advocates of alternative therapies for the lead role it has played in marginalizing unconventional cancer therapies in the United States. Whatever one’s view of these criticisms, ACS also has local chapters all over the country that can provide patients with information on cancer and cancer treatment, as well as referrals to a variety of support services and agencies that provide individual counseling and support groups, equipment and supplies, home care for patients, financial assistance, legal services, rehabilitation services, nursing home care, and hospice care. Some of these local ACS chapters are excellent. For many years, one of the best support groups in Northern California was sponsored by a local ACS chapter.
But, in evaluating unconventional cancer treatments, ACS has rarely lived up to the standard that would be of greatest assistance to patients and practitioners alike. It has tended to lump truly dangerous and bizarre alternative therapies with creative and compassionate experimental approaches to cancer that simply had not come up through the mainstream credentialed research system. [See discussion of the ACS “unproven cancer treatments” list, below.]
R.A. Bloch Cancer Foundation
4410 Main Street
Kansas City, MO 64111
Hot line: 816-932-8453
The R.A. Bloch Cancer Foundation is an unusual organization. It was created by Richard Bloch, cofounder of the tax preparation service, H&R Block. He funds it entirely, seeking no contributions from elsewhere.
The foundation has local services for Kansas and Missouri residents, and national services. The local services in Kansas City include support groups, biofeedback, and free second opinions from a panel of oncologists.
Nationally, the foundation offers a hot line staffed by volunteers. They do not discuss therapies but send out information packets. They can also refer you to counselors, who will call you collect but whose service is otherwise free. The foundation also operates a computerized cancer information network called “Cancer Forum” through which you can communicate free of charge with other cancer patients or with volunteer researchers. The cancer hot line also provides newly diagnosed cancer patients with the opportunity to talk with persons who have had cancers similar to their own.
Computer Database Searches
For cancer patients who like to see what their physicians have read (or should have read), nothing surpasses computerized database searches of the literature describing treatments for your cancer. If you have a computer with a modem, you can subscribe to one of the medical databases, such as BRS Colleague (1-800-955-0906). You then have access to the entire cancer literature of the world. With a few simple search words you can track down in seconds the articles on virtually any subject in the medical literature that has been written about in recent years. You can then display the titles of these articles on your screen, print these titles out, look at them, and circle the titles from which you want to read brief abstracts. You can go back into the database and ask for these abstracts, which you can print out. You can read the abstracts and then order the full text of any article you want from the service. In some instances, the database has the full text available for immediate printout through your computer.
The same computer database also gives you access to two NCI databases: the PDQ database on treatment choice for patients and the PDQ database for physicians on current clinical trials involving your type of cancer. The PDQ physician database is more interesting, and you can gain access to it as a layman. It lists all current clinical trials for your type of cancer, including complete details about who can qualify, what the investigational therapy is, possible side effects, etc. It gives the name of the chief investigator and a contact phone number.
The initial subscription fee for BRS Colleague is $95. The fee per hour for the use of the NCI CANCERLIT database is $32 during prime time (day) and $22 at other times. There is a $20 minimum monthly charge. A typical search might take 15 minutes; an extensive one would require half an hour or longer.
Medical School Libraries
Medical school libraries provide you with a wealth of information on cancer treatments at virtually no cost, except for photocopying. Often it is possible to do the same kind of computerized literature search described above. You simply ask the medical reference librarian to perform the search for you. You can then go to the stacks for the articles of interest to you. Libraries have the added advantage of having medical texts as well as journal articles.
As I have mentioned before, one of the best starting places for gathering basic information on your cancer and possible treatments is Cancer: Principles and Practice of Oncology, edited by Vincent T. DeVita, Samuel Hellman, and Steven A. Rosenberg (New York: Lippincott, 3rd ed., 1989). You may want to copy the chapter on your illness so you can take it home and read it with a medical dictionary. Starting with DeVita et al. will make the computerized literature search much more comprehensible.
Many major metropolitan hospitals have special libraries specifically designed for patients interested in educating themselves about their condition. Others have libraries for their medical staffs that patients can use, although some, quaintly, require a patient to have his physician’s permission to research his own disease. Some hospital cancer centers even have libraries devoted specifically to resources for cancer patients, including books, articles, video- and audiotapes, and community resources. The staffs of these libraries are available to help patients with their research. Many are also equipped for a fee to do computer literature searches on the more specialized questions you may have.
A model for this kind of patient information library is the Planetree Health Resource Center. The first Planetree Center opened in 1981 at the Pacific Presbyterian Medical Center (now California Pacific Medical Center) in San Francisco. Currently, four Planetree Health Resource Centers are in operation around the country (see below) and numerous other centers have adopted the model. Each Planetree Resource Center provides a range of services to patients, including a lending library, clipping file, computer database search service, and a customized in-depth health information packet which contains information about the range of conventional and complementary treatment options, articles, a bibliography, excerpts from medical texts, and a list of support groups and organizations.
Planetree Health Resource Centers are currently located in:
California Pacific Medical Center
2040 Webster Street,
San Francisco, CA 94115
Mid-Columbia Medical Center
200 East 4th Street
The Dalles, OR 97058
San Jose Medical Center
98 North 17th Street
San Jose, CA 95112
Beth Israel Hospital
1st Avenue at 16th Street
Silver Building, 8th Floor
New York, NY 10003
Consultants for Mainstream and Complementary Therapies
3111 Paradise Bay Road
Port Ludlow, WA 98365-9771
CanHelp is a resource service for people with cancer which has been directed by medical writer Patrick McGrady since 1983. It is a controversial service, praised by many users interested in unconventional treatments and criticized by others for a variety of reasons discussed below. Says McGrady, “I can help guide you through the maze of claims, counterclaims and putdowns regarding conventional and alternative therapies. I am not a doctor; I do not prescribe therapies; and I have no stake in any particular school of therapy or philosophy. In trying to locate your best options, I work with the best doctors I can find. As a medical writer, I am used to translating medical jargon into plain English and simplifying abstract concepts. When my search is completed, you are invited to discuss the options with me.”
Clients receive: a computer printout of research and treatment information from medical databases; a personal interpretation of this information; copies of relevant reports from CanHelp’s files; and a synopsis of conversations concerning your case with CanHelp’s medical advisors.
Clients must submit a series of medical documents, including pathology reports, surgical reports, blood work, and imaging reports such as computed tomography (CT) scans.
The fee for this service is $400 for American clients. In-person consultation costs $250 per hour. An initial brief telephone consultation is free of charge.
McGrady’s service, widely used by cancer patients interested in alternative treatments, is criticized on several grounds. For one thing, McGrady has been outspokenly critical of the American cancer establishment in his journalistic writing and in speeches, so physicians and patients who do not share his perspective do not like his service. Second, McGrady recommends a number of unconventional cancer treatments in many of his letters to patients that are on the “unproven treatments” list of the ACS. Third, at least one medical writer has written a detailed critique of the CanHelp Program arguing, among other things, that McGrady is involved in medical decision making beyond an appropriate level.1 Overall, the service appears to be appreciated by many patients who use it. I regard him as one of the most knowledgeable resource people in the field.
The Health Resource
209 Katherine Drive
Conway, AR 72032
The Health Resource is a medical information service founded in 1984 by Janice Guthrie. Guthrie describes the importance of her own research as a cancer patient: “The information I gathered helped me to locate a specialist interested in my particular type of tumor and enabled me to discuss intelligently my condition with him and to be an active participant in the decisions regarding my treatment. My research was so important to me in enabling me to make informed decisions, choose a combination of conventional and alternative therapies, and regain a sense of control over my personal health that I decided I wanted to do similar research as a service for other people with medical problems. This goal was compatible with my formal training in research and computer technology ….
Guthrie’s clients receive an in-depth research report that contains: information on conventional and alternative treatments for their specific cancer; profiles of cancer patients with the same type of cancer who have either recovered or outlived their life expectancy; a computer search of the medical literature on their cancer; a list of relevant clinical trials; copies of the latest medical journal articles discussing treatments for their cancer type (including the author’s address); information on coping with chemotherapy and radiation therapy (e.g., herbal, nutritional, and psychological techniques); suggestions for immunostimulation; and a list of recommended books on cancer.
Bound reports 110 to 150 pages in length cost $225 plus shipping. “Rush” service is available for an additional $75. Clients not satisfied with the report can return it within 30 days for a full refund.
Guthrie researches both mainstream and complementary therapies but does not have a strong advocacy stance that orients her clients toward a specific type of therapy. I regard Guthrie as a highly knowledgeable resource for people with cancer.
National Advocacy and Support Organizations
National Coalition for Cancer Survivorship
1010 Wayne Avenue
Silver Spring MD 20910
The National Coalition for Cancer Survivorship (NCCS) is a remarkable resource. It was founded in 1986 by Fitzhugh Mullan, M.D., a senior Public Health Service officer and cancer survivor, as a resource and advocacy group for cancer survivors. (Disclosure: I was on the founding Advisory Board.) NCCS provides support for persons wishing to locate or form self-help groups; assists survivors with insurance and employment problems; provides speakers on a wide range of topics; promotes the interests of survivors through the media; testifies in state and federal hearings; and provides a variety of publications of interest to survivors, including The National Networking Directory of Cancer Support Services. The NCCS also publishes the Networker, a quarterly newsletter that discusses issues affecting survivors.
NCCS is generally conservative on unconventional cancer treatments and more active on traditional issues of cancer survivors such as insurance, employment, and other social and bread-and-butter issues.
Individual memberships are $25, or less for those unable to pay the full amount.
Corporate Angel Network
Westchester County Airport
White Plains, NY 10604
Founded in 1981, the Corporate Angel Network is a nationwide service that transports cancer patients and a family member or friend free of charge to or from a “recognized cancer treatment,” using empty seats on corporate aircraft. When possible, transportation from the airport to the hospital is also arranged, along with hotel accommodations.
The only requirements of the service are that the patient be able to walk unassisted and that no life support or other special services be required. Flights are not guaranteed and backup plans are needed.
National Alliance of Breast Cancer Organizations
1180 Avenue of the Americas
New York, NY 10036
The National Alliance of Breast Cancer Organizations (NABCO) is a savvy information and advocacy umbrella group for the numerous grassroots breast cancer action and support groups that have blossomed nationwide. Its brochure describes it as “a non-profit, central resource that provides individuals with accurate, up-to-date information on all aspects of breast cancer, and promotes affordable detection and treatment … NABCO is also active in efforts to influence public and private health policy on issues that directly pertain to breast cancer–such as insurance reimbursement, health care legislation and funding priorities.”
NABCO is generally conservative on unconventional cancer treatments, and active on issues like improving insurance and funding breast cancer research.
A $40 annual membership in NABCO includes a subscription to the quarterly NABCO News, which monitors new developments relating to breast cancer, and NABCO’s annually updated Breast Cancer Resource List. The List is an extensive compilation of written and audiovisual materials from various sources and also contains regional listings for major support organizations. Free customized information packets addressing individual patients’ needs are also available upon request.
Y-Me Breast Cancer Support Organization
18220 Harwood Avenue
Homewood, IL 60430
Y-Me was founded in 1978 as a “not-for-profit organization that provides information, Hotline counseling, educational programs and self-help meetings for breast cancer patients, their families and friends.”
Y-Me has a toll-free hot line at 1-800-221-2141 (9 A.M.-5 P.M., CST) or 24 hours at 708-799-8228. Upon request, trained volunteers, all of whom have had breast cancer, are matched to callers with similar backgrounds and experiences. Presurgical counseling and practitioner referral are also available through the hot line.
Local chapters hold meetings with experts on various subjects of concern to breast cancer patients. Trained volunteers and staff members are available to present workshops to organizations and businesses stressing the importance of early diagnosis.
Y-Me has chapters in ten states and offers information and support to persons wishing to establish local support programs.
Y-Me is very conservative on unconventional cancer treatment issues. Chapters vary greatly in the quality of the service they provide.
Patient Advocates for Advanced Cancer Treatments
PO Box 1656
Grand Rapids, MI 49501
Patient Advocates for Advanced Cancer Treatments (PAACT) is a remarkable resource for prostate cancer patients that provides an iconoclastic and intelligent ongoing review of the latest developments in prostate cancer treatment.
It is a patient-oriented organization that was formed in 1987 “to act as a support and advocacy group for prostate cancer patients, their families, and the general public at risk.” PAACT’s founder, Lloyd Ney, is a former prostate cancer patient who rejected conventional therapy for his worsening condition in favor of an experimental therapy in Canada that was then unapproved for use in the United States.
Membership in PAACT requires a $50 yearly donation (or statement of inability to pay) and entitles the member to a subscription to the monthly Cancer Communication newsletter, which contains “the latest and most up-to-date information on treating prostate cancer.” However, a comprehensive packet of information on prostate cancer will be sent to anyone who requests it. The Prostate Cancer Report, updated periodically to include the latest research and treatment information, is also available. PAACT maintains a listing of prostate cancer support groups in 26 states.
In its role as patient advocate, PAACT takes an active role in promoting expedited new drug evaluation and approval by the Food and Drug Administration (FDA).
National Brain Tumor Foundation
323 Geary Street
San Francisco, CA 94102
The National Brain Tumor Foundation was founded in 1981 and has as its stated goals “improving the quality of life of brain tumor patients and finding a cure through research.”
In contrast to PAACT, the iconoclastic patient-driven review of what is happening with prostate cancer treatment, the National Brain Tumor Foundation tries to meet the needs of both patients and professionals, with a resultant tone of caution that almost always characterizes patient-professional cancer support and research advocacy organizations.
The foundation funds basic research and clinical trials at major research institutions throughout the United States, and also supports research in quality-of-life issues that face brain tumor patients. The foundation also offers assistance directly to patients and families, including: GUIDE, a comprehensive publication intended to educate patients and facilitate informed decision making; SEARCH, a newsletter that keeps patients in touch with advances in treatment and support options; nationwide referrals to support groups; and a volunteer-staffed phone line (1-800-934-CURE) that connects patients with professional caregivers and brain cancer survivors.
Leukemia Society of America
733 Third Avenue
New York, NY 10017
212-573-8484 or 1-800-955-4LSA
The Leukemia Society of America is a “national voluntary agency dedicated solely to seeking the cause and eventual cure of leukemia and allied diseases [lymphoma, Hodgkin’s disease, and multiple myeloma] …. The Society supports five major programs: research, patient-aid, public and professional education, and community service.” The society has 56 chapters in 36 states.
A wide range of written and audiovisual material about leukemia and current treatments is available through local chapters of the society. The society also places a high priority on maintaining local resource and referral materials for patients and their families. Many local chapters offer free support groups for patients and their families and friends.
The Leukemia Society also funds a patient assistance program for people unable to meet the high costs of treatment. The program provides up to $750 per year to patients for specific tests and procedures, drugs, and transportation.
The Leukemia Society is similar in tone to the ACS: it provides strong support for mainstream research and is very skeptical of unconventional cancer treatments.
Candlelighters Childhood Cancer Foundation
7910 Woodmont Ave.
Bethesda, MD 20814
Candlelighters is a nonprofit international network for support groups of parents of children with cancer that includes parents and other family members, health care professionals, and educators. Its goals include providing support systems for family members affected by children’s cancers; facilitating an exchange of information on research, treatment, medical, and community resources; identifying patient and family needs so that medical and social service systems respond adequately; and seeking consistent and sufficient research funding. The foundation also seeks to provide resources that link, on demand, professional services to family needs. There are no fees for Candlelighters membership or services.
Among its other activities, the national group issues quarterly and youth newsletters and various other publications and educational materials; acts as an information clearinghouse, including library and database searches; provides speakers; and helps in forming new local groups.
Candlelighters is a remarkable organization that tends to be conservative about unconventional cancer treatments for several reasons. First, it is primarily a mainstream group and most mainstream cancer support and advocacy groups take conservative positions on unconventional cancer therapies. Second, one of its leading organizers, Grace Monaco, is an attorney with an informed and generally skeptical perspective on unconventional cancer treatments (her views are widely criticized by proponents of many alternative therapies). Third, to a significant degree, childhood cancers have been responsive to advances in mainstream cancer treatments, and therefore advocacy of alternative treatments for children is even more controversial than advocacy of alternative treatments for adults.
Mainstream Treatment Centers and Comprehensive Cancer Centers
The NCI has selected a number of Comprehensive Cancer Centers throughout the country to act as leaders in laboratory, clinical, and cancer control and prevention research. These centers are also intended to be important resources for the communities in which they are located. Although, many metropolitan areas and some states do not have Comprehensive Cancer Centers, and many hospitals not designated as centers offer excellent care for cancer patients.
In order to be designated a Comprehensive Cancer Center, facilities must meet a number of criteria, including: having a strong program of basic research and research in cancer prevention and control; demonstrating an ability to transfer findings into clinical practice; conducting clinical studies and participating in high-priority clinical trials; providing training for health professionals; and offering a wide range of information and educational services for patients and health professionals in the community. The following is a list of currently designated Comprehensive Cancer Centers:
University of Alabama at Birmingham Comprehensive Cancer Center
Basic Health Sciences Building
1918 University Boulevard
Birmingham, AL 35294
University of Arizona Cancer Center
1501 North Campbell Avenue
Tucson, AZ 85724
The Kenneth Norris Jr. Comprehensive Cancer Center
University of Southern California
1441 Eastlake Avenue
Los Angeles, CA 90033
Jonsson Comprehensive Cancer Center
University of California at Los Angeles
200 Medical Plaza
Los Angeles, CA 90027
Yale University Comprehensive Cancer Center
333 Cedar Street
New Haven, CT 06510
District of Columbia
Lombardi Cancer Research Center
Georgetown University Medical Center
3800 Reservoir Road, N.W.
Washington, D.C. 20007
Sylvester Comprehensive Cancer Center
University of Miami Medical School
1475 Northwest 12th Avenue
Miami, FL 33136
The Johns Hopkins Oncology Center
600 North Wolfe Street
Baltimore, MD 21205
Dana-Farber Cancer Center
44 Binney Street
Boston, MA 02115
Meyer L. Prentis Comprehensive Cancer Center of Metropolitan Detroit
110 East Warren Avenue
Detroit, MI 48201
University of Michigan Cancer Center
101 Simpson Drive, Ann Arbor, MI 48109
Mayo Comprehensive Cancer Center
200 First Street Southwest
Rochester, MN 55905
Norris Cotton Cancer Center
Dartmouth-Hitchcock Medical Center
2 Maynard Street
Hanover, NH 03756
Memorial Sloan-Kettering Cancer Center
1275 York Avenue
New York, NY 10021
Columbia University Comprehensive Cancer Center
College of Physicians and Surgeons
630 West 168th Street
New York, NY 10032
Roswell Park Cancer Institute
Elm and Carlton Streets
Buffalo, NY 14263
Kaplan Cancer Center
New York University Medical Center
462 First Avenue
New York, NY 10016
Duke Comprehensive Cancer Center
PO Box 3814
Durham, NC 27710
Lineberger Comprehensive Cancer Center
University of North Carolina School of Medicine
Chapel Hill, NC 27599
Cancer Center of Wake Forest University at the Bowman Gray School of Medicine
300 South Hawthorne Road
Winston-Salem, NC 27103
Ohio State University Comprehensive Cancer Center
410 West 10th Avenue
Columbus, OH 43210
Fox Chase Medical Center
7701 Burholme Avenue
Philadelphia, PA 19111
University of Pennsylvania Cancer Center
3400 Spruce Street
Philadelphia, PA 19104
Pittsburgh Cancer Center
200 Meyran Avenue
Pittsburgh, PA 15213
University of Texas M.D. Anderson Cancer Center
1515 Holcombe Boulevard
Houston, TX 77030
713-792-2553 or 1-800-345-6324
Vermont Cancer Center
University of Vermont
1 South Prospect Street
Burlington, VT 05401
Fred Hutchinson Cancer Research Center
1124 Columbia Street
Seattle, WA 98104
Wisconsin Clinical Cancer Center
University of Wisconsin
600 Highland Avenue
Madison, WI 53792
Unusual Oncology Practices (Variations in Medical Practice)
This section gives four examples of what is sometimes referred to as “variations in medical practice.” The four practitioners listed below are credentialed physicians, oncologists, or hematologists, who have oncology practices that differ substantially from the norm. Some of them give consultations or workshops for patients who are visitors.
Keith Block, M.D.,
899 Sherman Avenue
Evanston, IL 60201
(See chapter 17 for a full description of the work of Keith Block).
Keith Block has his clinical practice in Evanston, Illinois, and is Medical Director of the Cancer Treatment Program and Medical Chief of Nutritional and Behavioral Oncology at the Edgewater Medical Center in Chicago. He is also a Clinical Instructor at the University of Illinois.
Block treats a wide variety of cancers and other catastrophic diseases using a multifaceted approach. His private practice and hospital programs include conventional treatment along with individualized adjunctive components, including nutrition, body maintenance, stress care, and psychological support. Block also conducts training workshops designed to give apparently healthy patients–as well as those suffering from more extreme, difficult-to-treat diseases–the tools and support necessary to meet the challenges of living with disease.
William Buchholz, M.D.,
851 Fremont Avenue
Los Altos, CA 94024
William Buchholz graduated from Stanford Medical School and is board certified in internal medicine and hematology. He has been in the private practice of medicine and oncology in Los Altos since 1978. His wife, Susan Buchholz, Ph.D., a clinical psychologist, works with him. The Buchholzes summarize the principles of their practice as follows:
1. “The whole person and his or her family and friends are affected physically, emotionally, and spiritually [by cancer]. A comprehensive treatment program recognizes this and addresses the unique needs of each individual, treating the person as well as the disease.”
2. “Conventional Western medicine has very powerful and useful treatments for certain cancers. Other aspects of treatment are better addressed by complementary therapies. Psychological techni-ques likewise are important in dealing with attitudes and emotions and their effects on recovery. A comprehensive program considers all of these systems and is inclusive rather than exclusive.”
3. “Developing a strategy to deal with cancer requires knowing not only what treatments to use but when to use them. Patients may correctly conclude that they must change their diet or deal with spiritual concerns. Such changes may have to be delayed, however, while surgery to prevent a bowel obstruction takes precedence. Fighting cancer alone is too exhausting–patients should use all their resources and support.”
4. “Although not everyone is cured, the potential for becoming whole again is possible for all of us. Each of us has the potential to be a hero, to grow wiser. We need to take care of ourselves, honor what is most precious within us, and at the same time become more forgiving of our own humanity. What makes cancer a heroic journey is the style in which it is done. What makes being doctors so rewarding is the chance to be with so many heros.”
Dr. Buchholz also offers workshops at his office on various subjects of interest to cancer patients.
Northwest Oncology Clinic
Cabrini Medical Tower
901 Boren Avenue, #901
Seattle, WA 98104
Glenn Warner, M.D., founder of the Northwest Oncology Clinics, is a board-certified radiation oncologist and immunologist. The clinic is a “`total care’ facility combining a full range of medical, therapeutic, and support services for the treatment of cancer … Your questions will be answered and you will participate in the decision-making process from the very beginning. The primary factor in treatment planning is the quality of the patient’s life. Our objective is to control the cancer without making the treatment worse than the disease.”
Warner’s view is that cancer is a systemic disease usually requiring more than one type of therapy. Among those available at the clinic are: surgery; radiation; chemotherapy, used within the overall goal of keeping the immune system active; immunotherapy, through the use of bacteria vaccines or other drugs; nutrition, vitamins, and exercise; and support therapies, such as individual and family counseling, relaxation techniques, imagery, and stress reduction.
In keeping with his belief in the importance of the immune system in fighting cancer, Warner believes that “the treatment program must be guided so that the person’s resistance is not suppressed. It is far better to come to our clinic before any therapy begins, rather than as a last resort.”
Dr. Warner does see people from all over the United States, but he also requires that patients make periodic visits to the clinic when necessary.
Falk Oncology Centre Limited
890 Yonge Street
Toronto, Ontario M4W 3P4, Canada
Rudy Falk, M.D., is a Professor in the Department of Surgery at the University of Toronto, and was for 8 years Head of the Division of General Surgical Oncology at Toronto General Hospital. In 1985, he formed the Falk Oncology Centre, an outpatient practice in Toronto. (Pat McGrady of CanHelp [see sec- tionêI under Consultants for Mainstream and Complementary Therapies, above] often recommends Falk.)
Falk describes his practice as a “combination therapy” that “emphasizes total patient care, including psychological and nutritional support.”
Falk says of his treatments: “There is an ongoing attempt for improvement; drugs that are more effective with less toxicity, treatments that will produce responses in patients where previous therapies have failed; improved equipment, technique, and methods.” Falk describes the rationale behind his approach:
When an abnormal situation arises in the body, prostaglandins are released, and although these are necessary in the body as a cytoprotective agent, when they are produced excessively they de-activate or block the function of the macrophage cell. The macrophages are the first line of theêimmune defense system and it is essential that these function. Non-steroidal anti-inflammatories [NSAIDs] have been known for a long time to block the excessive production of prostaglandins; however, unless they are combined with the carrier molecule, sufficient quantities of NSAIDs cannot be taken by patients without serious side effects.
The present therapy offered at the Falk Centre consists of low doses of chemotherapy combined with a carrier molecule, sodium hyaluronate, plus NSAIDs. Intravenous vitamin C is also given as a free radical scavenger to help rid the body of broken down cells, and hyperthermia is occasionally used as an adjuvant therapy to “stress” the cancer.
Spiritual, Religious, and Healing Resources
Many churches, synagogues, and other places of worship provide prayer services for people with serious illnesses. Some of these prayer services are rote activities, but others are authentic and powerful and are run by counselors trained in both spiritual and psychological therapies. Indeed, many medical centers today include psychological and spiritual counseling as vital elements in their programs. Churches and synagogues often provide psychological as well as spiritual approaches in the counseling they offer. Often such services are free of charge. Trained pastoral counselors may offer an attractive alternative to psychotherapy for those who prefer counseling in a spiritual context or cannot afford a psychotherapist.
The national professional organization that sets standards for some religious counselors is the American Association of Pastoral Counselors, 9504 A Lee Highway, Fairfax, VA 22031, 703-385-6967. The association certifies pastoral counselors and accredits pastoral counseling centers. The latter are usually independent nonprofit organizations or are connected with churches, seminaries, or hospitals. All counselors certified by the association have both psychological and theological training. The association can refer you to a counseling center or individual counselor in your area.
Many kinds of healers practice inside and outside traditional churches or religious institutions. Some churches offer laying-on-of-hands services for sick people, and often welcome people in need who have not previously attended the church. Tastes vary, but some of these services are authentic and powerful.
Few formal networks exist for locating healers. Tapping into the network of people in your community knowledgeable in this area is the most important first step. Cancer support groups are a good source of referrals to virtually any kind of practitioner, healers included. Inquiries through churches, listings in the local New Age directory, or natural food store bulletin boards are also good first steps. Ask as many questions of the practitioner as you need to in order to be assured that he is the right one for you. If he is not, he may be able to refer you to someone else.
The choice of a healer is a very individual matter, and it is extremely important that the fit be right. In order to realize the benefit of the relationship, you must have full confidence in the person and in the technique. If you do not, keep looking until you find a person you do trust and who can help you mobilize your own innate healing capacity.
Psychological Services and Support Groups
Psychiatrists (physicians trained in the diagnosis and treatment of the mentally ill), psychologists, licensed clinical social workers, medical social workers, and marriage and family counselors are all licensed to provide psychotherapy, but not all practitioners are specifically trained to understand and provide for the concerns of people with cancer and their families.
Finding the right therapist requires time and careful research. The field of health psychology is a new one, only recently recognized as a specialty by the American Psychological Association (APA). However, it is currently the largest category of psychologists in the APA. People with mental illness traditionally seek out psychiatrists, and they are the only mental health professionals licensed to prescribe medications for depression and anxiety. But most cancer patients are not mentally ill, and some psychologists are extensively trained in dealing with issues confronted by people with life-threatening illnesses.
If you live in a major metropolitan area, it can be relatively easy to find a therapist skilled in dealing with the psychological needs of people with cancer. Outside of metropolitan areas it is harder to find people so trained. One way to locate both therapists and support groups is through the local branch of the ACS, which often runs groups and makes referrals. Oncology centers in large hospitals often have departments of social work or psychiatry staffed with therapists. Hospitals can often make referrals, as well.
The local or state branch of the American Psychiatric Association or the American Psychological Association can be contacted to make referrals to members who have experience with cancer patients. Also, the American Society for Psychiatric Oncology/AIDS at Memorial Sloan-Kettering in New York (212-639-8010) has a national membership, and will give you the names and phone numbers of members in your area. The Association for Humanistic Psychology has a referral service (415-346-3246) in the San Francisco Bay Area which is expanding its base nationwide.
These are the more formal avenues for locating therapists. In reality many, perhaps most, people locate practitioners though less formal routes, often with good results. The physician managing your case may be able to direct you to a therapist. Many patients locate therapists simply by asking other cancer patients or members of support groups they attend. You can also contact hospices and other organizations that offer cancer support groups to get referrals.
A key point to remember is that you do have more than one choice: it is wise to interview more than one therapist and to ask about credentials and experience. It is also important to ask about the therapist’s training and experience in working with people with cancer. But training is not the whole story. In interviewing someone as a potential therapist, determine whether the therapist’s beliefs and attitudes are congruent with your own. Ask about the person’s philosophy of care, how he views illness and its causes, how he views body change, and even what his thoughts are about spiritual realities. Be sure to ascertain if he is available by phone nights and weekends, if he makes hospital visits, or conducts sessions on the phone.
If after three to five sessions your relationship with your therapist does not seem beneficial to you, do not be afraid to seek out another therapist. You have every right to expect the same sense of comfort, safety, and understanding with your therapist that you experience with a good friend.
Psychologists and psychiatrists are able to bill your insurance so that you may be partially reimbursed for their services. However, many insurance companies do not reimburse as completely for this kind of service as they do for physical health care, and some insurance policies do not cover these costs at all. It is important to read your policy carefully to see what services and what providers are covered by your insurance contract.
Generally speaking, therapists trained at the masters degree level are not able to bill insurance companies, whereas those with doctorates can. Exceptions to this are those therapists with a Marriage, Family, and Child Counselor degree (MFCC), who can often bill for insurance reimbursement.
If you are on Medicare, you may be able to have a psychologist’s expenses partially paid if your oncologist or primary care physician prescribes psychological therapy for you. Check with your local Medicare office and with your oncologist.
Many hospitals now offer cancer support groups. They vary greatly in quality. For information on which hospitals in your area may offer cancer support groups, look up “Hospitals” in the Yellow Pages of your telephone book. Call the department of oncology or the department of social services at the hospital and ask whether the hospital provides support groups for people with cancer and their families. The regional branch of the ACS is also a good source of information on local support groups.
The American Self-Help Clearinghouse (201-625-7101) is a national organization that can refer you to national self-help groups, as well as to state and regional clearinghouses that have information on local groups that are not members of national networks.
If you think that a support group might be useful to you, do not be discouraged if the first one you find does not suit your needs. Keep looking until you find the right one. Support groups vary widely depending upon the skills and orientation of the leader and the experiences and concerns of the members.
Often people find a support group most helpful when they are first diagnosed or are undergoing active therapy. However, participation in a group may become less useful over time. Review your experience of what you are receiving and do not hesitate to leave if you feel that the group is no longer beneficial to you.
There are also support groups for family members, spouses, and children which may be useful in some cases. People with cancer sometimes even organize their own personal support groups made up of their friends and family.
If no group exists that meets your needs and you are interested in starting one, the Self-Help Clearinghouse (see above) can provide information on model groups in other parts of the country and may also be able to connect you with others who have an interest in starting a group. Local clearinghouses are also good resources for starting groups.
The Consumers Union (1-800-272-0722) publishes a useful guide for cancer patients called Practical Resources for Cancer Survivors edited by Fitzhugh Mullan, M.D., and Barbara Hoffman, J.D., of the National Coalition of Cancer Survivors, which goes into considerable detail about how to find a suitable support group and also about how to organize a peer-support group yourself.
National Support Groups with Local Affiliates
The Wellness Community
2190 Colorado Avenue
Santa Monica, CA 90404
The Wellness Community is an excellent national network of cancer support centers imbued with the sane philosophy of its founder, Harold Benjamin, Ph.D. (see chapter 6).
The goal of the Wellness Community is to “provide a free program for people with cancer and their families where educational, emotional, and social support create an atmosphere of hope in which patients can actively participate in their fight for recovery.”
The Wellness Community seeks to provide a homelike setting for people with cancer where they can come to be with others in the same situation. These centers offer informal sharing groups, ongoing weekly groups facilitated by psychotherapists, family groups, relaxation and visualization sessions, workshops and lectures conducted by experts in a variety of topics, exercise and nutrition classes, social events, and groups designed to facilitate the exchange of information in specialized areas of concern to cancer patients.
The Wellness Community is expanding nationwide; and currently has centers in the following cities:
2200 Colorado Avenue
Santa Monica, CA 90404
Los Angeles/South Bay
109 W. Torrance Blvd.
Redondo Beach, CA 90277
100 No. Hill Avenue
Pasadena, CA 91106
5655 Lindero Canyon Road
Westlake Village, CA 91362
1924 E. Glenwood Place
Santa Ana, CA 92705
3760 Convoy Street #320
San Diego, CA 92111
San Francisco/East Bay
350 No. Widget Lane #101
Walnut Creek, CA 94598
1110 Jorie Blvd.
Oakbrook, IL 60521
Greater St. Louis
12 South Hanley
St. Louis, MO 63105
Towers of Kenwood
8044 Montgomery Road #385
Cincinnati, OH 45236
1844 Terrace Avenue
Knoxville, TN 37916
P.O. Box 65247
Baltimore, MD 21209
Balapointe Office Center
111 Presidential Blvd.
Bala Cynwyd, PA 19004
1146 Beacon Street
Brookline, MA 02146
Center for Attitudinal Healing
19 Main Street, Tiburon, CA 94920
The Center for Attitudinal Healing was founded in 1975 by Gerald Jampolsky, M.D., the author of the internationally known Love Is Letting Go of Fear.2 The center’s aim is to “supplement traditional health care through an environment in which children, youth, and adults faced with life-threatening illness can actively participate in the process of attitudinal healing. The Center is not about illness or dying, but rather about the quality of life no matter what the circumstances.” It has a strongly spiritual orientation.
“The concept of attitudinal healing is based on the belief that it is possible to choose peace rather than conflict, and love rather than fear … Attitudinal healing is the process of letting go of painful, fearful attitudes. When we let go of fear, only love remains. At the center of our definition of health is inner peace, and healing is the process of letting go of fear.”
The center offers a wide variety of support programs for children, youth, and adults. In addition to serving people with life-threatening illnesses, the center also provides support for people dealing with long-term illness, caregivers and family members, and those dealing with bereavement. Workshops and training programs in attitudinal healing are also available. The center publishes a quarterly newsletter and also has a catalogue of books, videos, and audiotapes.
The Center for Attitudinal Healing office in Tiburon, maintains an extensive listing of Attitudinal Healing programs and other centers in the United States, Canada, and Australia whose philosophies and approaches are similar to its own. The list is available upon request.
Major Metropolitan and Regional Support Groups
The following is only a sampling of some of the better-known regional support organizations for people with cancer. The local chapter of the ACS can provide a more exhaustive list of support groups in your area.
The Behavioral Medicine Program for Cancer Patients
New England Deaconess Hospital
185 Pilgrim Road
Boston, MA 02215
The Behavioral Medicine Program for Cancer Patients is a highly regarded medical outpatient clinic designed to help patients deal with the stress of the disease and of the side effects of treatment, and to help the patient take an active role in his care.
Patients are trained in the practice of the relaxation response, which “is elicited by mental focusing techniques, which bring about measurable physiological changes, including decreases in heart rate, blood pressure, and muscle tension. These changes can counteract many of the physical effects of stress.” Stretching exercises, awareness training, breathing techniques, nutrition information, and use of “creative imagination” in a state of deep relaxation are also employed.
The staff includes psychologists, a social worker, and support personnel. The program is offered in groups of 12 to 15 in order to allow participants to realize the benefits of interacting with others who have had a similar experience. Groups run for 9 weeks and each session lasts 2 hours. Follow-up programs are available for patients completing the program, in order to help them maintain the practice of the techniques learned to provide continuing support.
The fee for the initial assessment is $300 and each of the group sessions is $60. The discharge assessment fee is $150. Coverage of services by insurance policies varies. For some patients there is an interest-free installment payment program and scholarship support is available in selected cases.
Stress Reduction Clinic
University of Massachusetts Medical Center
Worcester, MA 01655
Jon Kabat-Zinn, Ph.D., Director of the Stress Reduction Clinic, is one of the outstanding pioneers of meditation-based programs for people with cancer and other illnesses. He describes the clinic program as “an eight-week-long course designed to teach people with a wide range of chronic medical diagnoses and varying degrees of chronic stress, pain, and illness how to take care of themselves as a complement to the care and treatment they are receiving through more traditional routes. The core of the program is a relatively intensive training in mindfulness meditation and its application in daily living to coping with stress and pain.”
A physician referral is required for a patient to be considered for the program. Patients with cancer–as well as other medical conditions–are evaluated individually, and then, if appropriate and sufficiently motivated, enrolled in the program. Thirty people attend one 2 hour session per week, plus an all-day Saturday session during the sixth week. Participants are required to devote a minimum of 1 hour daily, 6 days a week, to the practice of mindfulness techniques, with guidance from audiotapes.
Kabat-Zinn’s book, Full Catastrophe Living,3 provides a detailed description of the program and its orientation.
Wellspring Center for Life Enhancement
3 Otis Street
Watertown, MA 02172
Wellspring Center provides services for people with life-threatening and chronic illnesses as well as those who care for them. These include support groups, consultations to discuss relevant resources and referrals, an audiovisual lending library, and a program in which persons with illness and family members can receive support and instruction in relaxation and visualization either at home or in the hospital.
Training and consultations are also available to hospitals, hospices, churches, and professional organizations.
Exceptional Cancer Patients
1302 Chapel Street
New Haven, CT 06511
Exceptional Cancer Patients (ECaP) was founded in 1978 by Bernie Siegel, M.D., author of Love, Medicine and Miracles and other books.4 Siegel is one of the most famous, and still controversial, advocates of mind-body approaches to cancer which “help people find the strength to grow and change in the face of serious health problems.”
According to the organization’s literature, the ECaP therapeutic model, used as an adjunct to mainstream medical therapies, is intended to encourage patients to participate in their own process of healing. “Individuals are supported in making emotional and spiritual changes which may lead to a better quality of life and, secondarily, to an extension of their lives.”
ECaP offers group sessions, psychotherapy for individuals, couples, and families, education and support for AIDS patients, an extensive mail-order catalog of books, cassettes, and videotapes which convey the ECaP philosophy, and a health professional training program.
ECaP groups meet once a week for 2 hours, and are facilitated by two psychotherapists. Individuals must submit an application, followed by a 2-hour intake consultation with a therapist. The individual is then assigned to one of the eight ongoing groups according to his unique needs. Fees are based on a sliding scale, and patients are encouraged to participate in groups for a minimum of 3 months.
ECaP also maintains a referral service to groups with similar philosophies nationwide.
SHARE: Self-Help for Women with Breast Cancer
19 W. 44th Street
New York, NY 10036
Hot line (English): 212-382-2111
Hot line (Spanish): 212-719-4454
Hot line (Chinese): 718-296-7108
SHARE is a highly regarded center that offers support groups for women with breast cancer, including groups in Spanish and Chinese, and a number of special groups, such as newly diagnosed patients, seniors, and patients with ovarian cancer. SHARE also operates a patient hot line (also multilingual) and presents an ongoing educational series on issues of interest to breast cancer patients. Generally, it has an outstanding reputation among women who use the service in New York.
San Francisco Bay Area
Cancer Support Community
401 Laurel Street
San Francisco, CA 94118
The Cancer Support Community in San Francisco is an excellent example, as is SHARE in New York, of the benefits of a quality-oriented independent support program for cancer patients. It offers a variety of programs for cancer patients, their families, and caregivers. All services are provided free.
Support programs include groups, grief counseling, individual, couple, and family counseling, and home and hospital visits. Classes in relaxation and stress reduction, pain management, guided imagery, biofeedback, nutrition, and exercise are also available. The organization has a library and information and referral center.
Women’s Cancer Resource Center
3023 Shattuck Avenue
Berkeley, CA 94705
The Women’s Cancer Resource Center is another example of a high-quality, independent support program. It provides a number of free (donations requested but not required) services to women with cancer, including support groups, yoga and relaxation classes, educational events, and a library, referral, and information service.
Cancer Support and Education Center
1035 Pine Street
Menlo Park, CA 94025
The Cancer Support and Education Center offers an intensive course for cancer patients and family members in which “you will learn how to turn hopelessness and helplessness into a strong will to live. You will learn how to feel empowered to work in partnership with your physicians. We will teach you techniques to work with your medical treatment as an ally, to enhance its effectiveness. You will be assisted in discovering untapped resources for healing and living more fully.”
The self-help intensive course is presented in two formats: 1 day a week for 7 hours over a 10-week period, or 10 consecutive weekdays.
Nutritional consultation, medical consultation, massage, and individual, couples, and family counseling are also available on a fee basis.
Washington, D.C. Area
Medical Illness Counseling Center
Chevy Chase Metro Building, Suite 530
Two Wisconsin Circle
Chevy Chase, MD 20815
The Medical Illness Counseling Center is a high-quality counseling program in the Washington, D.C. area, with an excellent local and national reputation. It “specializes in helping families with medical problems. [Its] professional services are directed toward decreasing emotional stress, physical symptoms, disability, and the undesirable side effects of various treatments.” It also works with people who have been recently diagnosed with a serious illness, are experiencing chronic pain, preparing for major surgery, have a terminal illness, or have recently experienced the loss of a loved one.
The staff at the center includes psychiatrists, psychologists, social workers, nurse clinicians, and registered nurse therapists. They refer, when appropriate, to self-help groups and spiritual counseling. The center works with children, adolescents, and adults. Involvement by the entire family is encouraged.
After an initial visit, a treatment plan is developed which may include: psychotherapy, group therapy, family therapy, biofeedback, hypnosis, guided imagery, physical therapy, sex therapy, or medication.
Fees for various services can be obtained by telephoning the center, and a sliding scale is available for qualifying individuals. When services are covered, the center also accepts Medicare.
Residential Programs for People with Cancer
Commonweal Cancer Help Program,
PO Box 316
Bolinas CA 94924
Founded in 1985, the Commonweal Cancer Help Program (our program) offers six weeklong retreats each year for people seeking physical, mental, emotional, and spiritual healing in the face of cancer. This is a nonmedical, education program for patients under the care of a physician. The retreats are intended to provide participants with the opportunity to reduce the fear and stress associated with cancer, to examine personal beliefs and behaviors that do not contribute to well-being, and to explore the ways of living and choices in treatment that may be of benefit.
The retreats include experiences with yoga, meditation, imagery, progressive relaxation, massage, vegetarian diet, art therapy, poetry, classes on informed choice in cancer therapy, daily support group meetings, and opportunities for people with cancer to learn from one another. Each retreat is limited to a total of eight cancer patients and/or support people. The fee is $1,280. Some scholarships are available.
Simonton Cancer Center: New Patient Program
PO Box 890
Pacific Palisades, CA 90272
The New Patient Program is a 5-day educational and psychotherapeutic session for cancer patients and their spouses conducted by O. Carl Simonton and the staff of therapists at the Simonton Cancer Center. Simonton is co-author of the widely read Getting Well Again and other books.5 He and his former wife, Stephanie Simonton, pioneered mental imagery as an adjunctive approach to cancer.
The program focuses on the influence of belief systems. Participants learn techniques for enriching their lives in order to promote their health, lifestyle counseling, and relaxation and mental imagery exercises. Patients also explore the importance of gentleness, the role of stress, secondary gain from illness, and other contributing factors to disease. The issues of recurrence and death are also examined.
Because of the importance of emotional support for the patient, spouses or “most significant others” must attend the program.
The total cost of the program is $3,250, which may be fully or partially covered by some insurance policies.
Optimum Health Institute
6970 Central Avenue
Lemon Grove, CA 92045
The Optimum Health Institute offers a 3-week course in “rejuvenation” through diet, various health practices, and attitudinal adjustment. (See Optimum Health Institute under Unconventional Nutritional Programs, below).
The cost of the program per week for a private room is $365.
Vega Study Center
1511 Robinson Street
Oroville, CA 95965
The Vega Study Center offers a 12-day “Cancer and Healing” program every other month. The fee for the program is $1,095, or $995 for registration 1 month in advance. (See Vega Study Center, under Unconventional Nutrition Programs, below).
Bristol Cancer Help Centre
Clifton, Bristol BS8 4PG, England, United Kingdom
The Bristol Cancer Help Centre offers a weeklong residential course which employs group support, meditation, visualization, and self-help techniques to assist patients in adjusting to the experience of cancer and cancer treatment. (See Bristol Cancer Help Centre, below).
The cost of the residential course is £350. Scholarships are available.
The Yarra Valley Living Centre
PO Box 77G
Victoria 3797, Australia
The Gawler Foundation (see the discussions of Ian Gawler in chapters 10 and 13) conducts two residential programs for people with cancer at its Yarra Valley Living Centre, both conducted by Ian and Gayle Gawler.
The initial 10-day program focuses on developing self-help techniques and coping skills. Other aspects of the program are: transforming fear into positive action; developing peace of mind; personal pain control techniques; improving communication skills; personal development through disease; and a workshop using drawing to gain personal insight. A 5-day follow-up program focuses on problem solving and application of the techniques.
Nutritional Therapies–Mainstrean, Complementary, and Unconventional Complementary and Mainstream Nutritional Therapies
Good mainstream and complementary nutritional counseling for cancer patients is not always easy to find. If you are interested in incorporating a nutritional component in your treatment and health-promotion regimen, you may wish to locate a mainstream dietitian or nutritionist to assist you. Or you may wish to seek out an experienced complementary nutrition educator. Cancer support groups are possible sources of referral to dietitians and nutritionists who have worked with cancer patients, as are physicians and nurses.
Referrals to mainstream dietitians in your state can be obtained through the American Dietetic Association (1-800-366-1655). Dietitians have received training based on current mainstream research on nutrition and have had at least 4 years of undergraduate training, participated in an internship, and have passed a registration test. Some states also have licensing requirements for dietitians.
Standardized educational requirements do not yet exist in most states for nutritionists or nutrition educators, so there is great variability in the kind of training they bring to their work with people with cancer. Some are university caliber researchers. Others have no business offering advice to cancer patients or anyone else. Inquire about the level of formal training that the nutritionist has completed and the nature and extent of his training with other practitioners in the field. Lack of standards for training does not necessarily mean that many nutritionists are not qualified to work with people with cancer. On the contrary, many have masters degrees or doctorates and bring a very broad perspective to their work. But it is important for the person with cancer seeking nutritional guidance to be cautious.
Like the search for any health care practitioner, consider training, but also look beyond it for someone who listens carefully and is willing to support your independent efforts to heal yourself. When you interview nutritionists or dieticians, be specific. Ask what kind of diet the practitioner would recommend for you and why. Describe your ideas for an anticancer diet and ask what he thinks of it. Also ask the practitioner to refer you to other cancer patients that he has worked with, and for a bibliography of nutrition resources that the nutritionist respects.
In assembling a team to work with you on a treatment and health maintenance program, it is important to understand that dietitians and nutritionists are not primary care providers and so do not treat cancer. They are able, however, to translate diet theories into practice, a skill which most physicians do not have. Many nutritionists are also capable of helping you implement a nontraditional nutritional therapy if you choose to pursue one, since many of these therapies are inherently health-promoting when carried out in a sensible manner. In any case, it is wise to arrange a conversation between your physician and nutritional consultant to ensure the best possible coordination of your care.
Unconventional Nutritional Programs
The following unconventional nutritional programs are not supported or recommended by mainstream medical experts. They represent a reasonable sampling of some of the better-known “alternative” nutritional programs.
The Kushi Institute
PO Box 7
Beckett, MA 01223
(See chapter 15 for a discussion of macrobiotics.)
The Kushi Institute’s curriculum on macrobiotic diet and lifestyle ranges from “the practical basics of natural, whole foods cooking to the comprehensive studies of macrobiotic healing arts. It is offered to individuals who want to establish their health and deepen their comprehension of the relationship between body, mind, and spirit.”
The Macrobiotic Residential Seminar is a weeklong residential program that includes daily cooking classes and lectures on the theory and practice of macrobiotics. The cost is $895 and the course is limited to 18 people.
The institute also offers a more intensive “Leadership Training” program in three 5-week sessions, each of which covers the following five subject areas: “order of the universe, macrobiotic cooking, shiatsu and ki-energy adjustment, macrobiotic health evaluation, and macrobiotic health care.” The cost of a 5-week session is $2,495.
Other Beckett, MA, seminars and an annual, summer weeklong conference in rural Vermont are described in the Kushi Institute’s program brochure, which is available on request.
Vega Study Center
1511 Robinson Street
Oroville, CA 95965
The Vega Study Center and the affiliated George Ohsawa Macrobiotic Foundation were founded by Herman and Cornellia Aihara. The center offers a number of residential courses ranging from 3 to 12 days in length. Courses in basic macrobiotic theory are offered, as well as cooking classes and more specialized workshops.
A 12-day “Cancer and Healing” program is offered every other month. Included in the schedule are instruction in preparing low fat, low cholesterol, sugar- freeêmeals; the macrobiotic perspective on healing, emotions, and overcoming fear; communication with medical practitioners; and demonstrations of “home remedies.”
Regular fees are: $150 per day, $595 per week, and $1,095 for 2 weeks, all inclusive.
PO Box 430
Bonita, CA 91908
(See chapter 14 for a description of the Gerson therapy; see also Centro Hospitalario del Pacifico S.A. under Mexico in section XII, below.)
Ann Wigmore Foundation
196 Commonwealth Avenue
Boston, MA 02116
The Ann Wigmore Foundation is popularly known for its wheat-grass and alternative nutritional therapy. It offers a 1- or 2-week residential course called “Living Food Lifestyle” for “people with allergies, heart disease, and other `incurable’ conditions.” Ann Wigmore describes her beliefs about and approach to cancer in the foundation literature:
The role of nutrition in cancer has been confirmed by new scientific observation which shows that the cause [of cancer] is twofold: 1) The blood is lacking in organic mineral elements and true nutrients out of which healthy, vibrant cells are created, and 2) the blood and consequently the tissues have become so saturated with waste and foreign matter that the life of the individual is being threatened. As a safety measure, the body builds at a rapid pace cancerous cells from the blood pollutants and reduces the impurities of the blood. My work with cancer patients has proven beyond the shadow of a doubt that constipation is the greatest crime against health and is the cause of cancer in many instances. Important steps such as enemas, colonics, and wheatgrass implants must be taken in order to get the colon back to health. And, of course, letting go of fear enables the body to heal.
The course “… assist[s] you in making lifestyle changes necessary for self-healing. We emphasize reversing the aging process with exercise, affirmation, visualization, yoga, relaxation and transformational activities.”
The curriculum includes: internal cleansing; growing greens and wheat-grass; composting and soil management; indoor gardening; sprouting; food-combining; energy soup; rejuvelac (a fermented wheat preparation); dehydration; fermentation; recipes; traveling with living food; weight loss; and sessions with Ann Wigmore.
The cost for the 2-week course is $1,150 for a private room, $850 for dormitory accommodations, and $550 for day students.
The Living Food Lifestyle program is also offered at the affiliated Ann Wigmore Institute, PO Box 429, Rincon, Puerto Rico 00677, 809-868-6307).
Ann Wigmore is the author of a number of books sold though the institute, which also sells a video about the program and numerous “accessories” such as juicers, dehydrators, sprouters, and water filters.
Optimum Health Institute
6970 Central Avenue
Lemon Grove, CA 92045
The Optimum Health Institute was formerly affiliated with Ann Wigmore’s Boston organization, which at the time was called the Hippocrates Institute. The philosophical basis of both institutions is quite similar in that both emphasize the rejuvenation of the body through a diet of “living foods,” employment of various health practices, and attitudinal adjustment. Raychel Solomon, founder of the Optimum Health Institute, describes her approach to health in her book Coming Alive with Raychel, available through the Institute.6
The Optimum Health Institute offers a 3-week residential course, though 1- or 2-week stays are possible, but not recommended. The program includes daily exercise and sessions on food combining, organic gardening, rejuvelac, sauerkraut, sprouting, growing and using wheat grass, recipes, menu planning and kitchen setup, natural beauty care, pain control and relaxation techniques, and training in self-esteem and mental and emotional “detoxification.”
The cost of the program per week for a private room is $365.
Nicholas Gonzalez, M.D., P.C.
36 East 36th Street, Suite 204
New York, NY 10016
Dr. Gonzalez completed his undergraduate work at Brown University and graduated from Cornell University Medical College in 1983. As a senior student at Cornell he became interested in alternative approaches to the generally accepted means of treating cancer. One of these alternative approaches was to try to treat cancer by nutritional means. While a student pursuing a senior elective, Gonzales decided to study the cancer treatment developed by a radical alternative practitioner, William D. Kelley.
During this period and in subsequent analysis while a fellow training in clinical immunology and bone marrow transplantation, Gonzalez conducted an extensive review of case histories of patients he found had done well on the Kelley nutritional and psychological program.
The treatment Gonzalez offers, based on Kelley’s work, consists of an intensive nutritional program which involves three parts: diet, supplementation, and detoxification. The program is highly individualized, with diets ranging from vegetarian to diets high in animal protein. Supplements consist of vitamins, minerals, glandular concentrates, and enzymes. A patient may be required to take as many as 150 capsules a day as part of the regimen.
The detoxification protocol involves coffee enemas which “help clear the body of metabolic wastes.” Patients must be able to eat and do the coffee enemas in order to benefit from the treatment.
All patients are treated on an outpatient basis. The fee for the initial evaluation, consisting of two lengthy sessions, is $1,500. During the first session–usually lasting about 1 1/2 hours–Gonzalez takes a complete patient history and performs the physical examination. During the second session–usually 1 to 2 hours long–Gonzalez reviews the results of the evaluation and tests with the patient and describes the treatment program. Phone consultations during the course of treatment are free of charge, but blood tests require an additional fee.
The supplements are sold through a separate mail-order source. Their cost varies from patient to patient but can be expected to average about $400 per month during the course of treatment.
Livingston Foundation Medical Center
3232 Duke Street
San Diego, CA 92110
(See chapter 16 for a discussion of the work of Virginia Livingston; see also Livingston Foundation Medical Center, under Alternative and Complementary Treatment Centers, below.)
Physical Therapies–Mainstream and Unconventional
(See chapter 18 for a discussion of massage.)
Massage can be a relaxing and revitalizing experience for people with cancer. Many different styles of massage or bodywork are available. Therapeutic touch does not involve actual physical touch at all, while Swedish massage (perhaps the most common style) can range from light stroking to deep tissue work. Acupressure is based on the same traditional Chinese medical model that acupuncture uses, except that it involves the use of finger, palm, or elbow pressure on the meridian points, rather than needles. Jin shin jitsu, jin shin do, and jin shin are also varieties of acupressure. Shiatsu is a traditional form of acupressure that involves working with meridians (lines of “qi energy” in the human body, as yet unproven by Western medicine) as well as points on the meridians and which also uses range-of-motion techniques.
Beyond basic technique, practitioners vary in their gifts, skills, and training; how they combine styles; how sensitive they are to the needs of their clients; and how experienced they are in working with people with cancer. Be prepared to talk to a variety of practitioners and to have an introductory massage with several. Consider whether the practitioner is certified by a school licensed by the state and accredited by a major organization such as the American Massage Therapy Association.
For the cancer patient interested in massage, the best source for referrals is a support group where other cancer patients can recommend a practitioner who is competent and understands the needs of people with cancer. The American Massage Therapy Association (AMTA) (312-761-2682) can give you a number to call in your state for referrals to an AMTA member in your area who practices the style of massage you are interested in. However, membership in the association is not required to practice, and many competent massage therapists are not members. In the same way, the American Oriental Bodywork Therapy Association (516-365-5025) can supply a list of acupressure practitioners nationwide or can refer you to a state representative.
While massage is often helpful, it can also be harmful. Inappropriate massage technique can break a bone weakened by cancer metastases, especially a vertebra in the spine. This danger is known and described in the literature on chiropractic as discussed in chapter 18. It is usually possible to minimize this danger by telling your masseur where any bone metastases are and having him avoid deep pressure in those areas. Ideally, you would find a massage practitioner who has worked with people with cancer. You might arrange a conversation between your physician and the massage practitioner to discuss any contraindications to massage. It is also worth noting that the massage practitioner could conceivably be the first person to notice new tumors. You may wish to discuss this possibility with the practitioner in advance and decide how he would communicate such a finding.
(See chapter 18 for a discussion of Therapeutic Touch.)
Therapeutic Touch, as discussed in chapter 18, is a modern version of the ancient system of “laying-on-of-hands” except that the hands are kept slightly above the body. Some kind of scientifically unexplained interaction between the practitioner and the patient has been shown in a number of studies to beneficially change blood chemistry values and to be associated with other physical benefits.
Therapeutic Touch is often valuable for people who dislike or should not experience direct touch–and even for those who can. Many nurses are trained in Therapeutic Touch. Some hospitals allow nurses to use it in the hospital. It is an approach to mind-body healing worth exploring for those who wish a modern approach associated with a research literature.
Referrals to Therapeutic Touch practitioners nationwide can be obtained through the Center for Human Caring at the University of Colorado (303-270-6157).
Reiki is culturally “farther out” than Therapeutic Touch, but it is a widely disseminated system and hence worth noting here because of its accessibility. Reiki teacher and practitioner Beth Gray describes the technique as “involving the laying-on of hands to channel energy in a particular pattern. It is entirely gentle and stimulates the body’s own innate wisdom to cure at the cause of the problem, promoting a holistic balancing of the body, mind, and spirit.”
Reportedly an ancient technique, it was “rediscovered” in the 1800s by Dr. Mikao Usua, a Christian minister in Kyoto, Japan. Reiki practitioners, or “channels,” have completed a process of “attunement” or “fine-tuning” with a Reiki master. “Once a Reiki channel has been `turned on,’ it is simply a matter of using the energy. It is used to bring balance and aid healing in others, but the channel can also direct energy to himself or herself.”7
Treatments involve the placing of the practitioner’s hands on various parts of the body, often for an hour or more:
The Reiki channel does not really attempt to “diagnose” or “treat” the subject person. … From the experience of giving Reiki, the channel may make some intuitive guesses as to the subject’s underlying condition. However, there is no need to diagnose, because the channeler will cover all parts of the subject’s system anyway–and the apparent symptoms are often not really the root cause. As for the treatment, it is more a question of the subject’s own system being opened up and allowed to get involved in the healing process. … There is no clear, rational explanation of how Reiki energy works.8
Reiki practitioners can often be found listed in the New Age directory for your area, if there is one, or through the Reiki Alliance at PO Box 41, Cataldo, ID 83810; 208-682-3535. However, according to Heather Riley of the Reiki Center in Woodside, California (408-997-1758), any person interested in long-term Reiki work can simply receive training from a Reiki master (typically over a weekend) and perform Reiki on himself.
Yoga Classes and Retreats
(See chapter 9 for a discussion of yoga.)
Yoga is an approach to stress reduction that many cancer patients have found useful in increasing their capacity to manage stress. The greatest danger of yoga to a person with cancer is the same as the greatest danger of massage, chiropractic, or other forms of bodywork. Some yoga poses could add physical stress to bones weakened by cancer metastases and contribute to a bone breaking. The danger is particularly great with metastases to the spine, since yoga works to increase the flexibility of the spine.
Many systems of yoga are currently taught in the United States. Though they all arise out of a common tradition, they can vary considerably in their relative emphasis on the physical, breathing, and meditation practices and even on their approach to each of these elements of yoga. Most beginner-level classes focus on the physical poses but also introduce students to the breathing practices, meditation, and sometimes relaxation techniques, as well.
It is important to find a method and teacher that suit your needs. You may have to attend several different classes in order to find one that is right for you.
Locating a yoga teacher can be quite easy in most cities. The Yellow Pages has listings under “Yoga” of individuals and organizations that offer classes. Organizations also tend to offer, in addition to the basic beginner’s classes, more specialized workshops or course classes that will allow you to explore aspects of yoga that are particularly useful to you. Some also offer extended retreats where participants can immerse themselves for a period of time in a yogic lifestyle, an experience that can be restful, and even transformative.
The Yoga Journal, 2054 University Avenue, Berkeley, CA 94704, 510-841-9200 or 1-800-359-YOGA, publishes an annual directory of yoga teachers and organizations nationwide which can be useful for finding teachers and also yoga retreats. Natural foods stores often have notices for classes, as do local New Age directories often found at these stores. Of course, a personal recommendation–especially from another cancer patient–is probably the best way to locate a good yoga teacher who is sensitive to the needs of people with cancer.
Until you are very familiar with the style of yoga you have chosen–regardless of the gentleness of the practice–it is very important to inform the teacher of your physical condition and to ask if there is any part of the class that you should not participate in. Among its other benefits, yoga brings about a gradual deepening of your awareness of your body, including its strengths and limitations. It is important for anyone, but especially for people with cancer, to be very gentle with the practices as this awareness is developing.
These are some of the yoga systems that people with cancer have found useful:
Integral Yoga Institute
Route 1, Box 1720
Buckingham, VA 23921
The Integral Yoga Institute has branches in many cities, with major institutes in New York and San Francisco. Most of these centers offer beginner and advanced beginner-level classes in yoga. Both drop-in and 4- to 6-week course classes are offered. These are fairly standardized and vary only slightly from center to center.
The 1 hour drop-in classes focus on a very gentle and meditative style of hatha yoga and also include a guided deep relaxation, instruction in basic yogic breathing practices, and a brief instruction in meditation. Because it is such a gentle practice and because the classes provide at least an introduction to several components of yoga, many people have found Integral Yoga to be a good introduction to yoga, even if they choose to incorporate elements of other styles as they gain in proficiency.
Most Integral Yoga institute centers also offer workshops or course classes in subjects such as meditation, vegetarian cooking, and the philosophy of yoga.
The institute also offers two silent yoga retreats approximately 1 week in length, one in the summer at its Virginia center and between Christmas and the New Year in California. (Personal disclosure: I was trained in Integral Yoga.)
Iyengar Yoga Institute
8233 West 3rd Street
Los Angeles, CA 90048
The approach to yoga in the Iyengar method differs markedly from that of Integral Yoga. Iyengar yoga is considered rigorous, even by people whose health and stamina is good. Because of this, it is particularly important that you discuss your physical condition with the teacher before you join a class. On the other hand, Iyengar teachers may offer special programs for people with health problems.
The focus in Iyengar yoga is on physical, or hatha yoga, practices. As the method is described in the institute’s literature, “Mr. Iyengar’s approach is marked by dynamism and precision. Iyengar yoga is unsurpassed as a way to build strength, stamina, and flexibility while cultivating a sense of graceful purpose and well-being … Iyengar yoga is meditation in action; the self is explored through the discovery and release of tension patterns and psychological resistances. As practice continues, a student’s ability to relax and concentrate generally improves markedly, and his or her inner awareness is enhanced.”
Iyengar teachers receive extensive training and Iyengar yoga is probably taught by more teachers than any other method in the country.
1258 Mansfield Avenue N.E.
Atlanta, GA 30307
Viniyoga is taught by Desikachar, a yoga teacher based in Madras, India, with students around the world. While both integral yoga and Iyengar teach standard sets of yoga poses and practices, Desikachar teaches his yoga teachers to individualize the poses and other practices that each student undertakes. A well-trained teacher in Deskikachar’s method can be a great gift to a yoga student with special needs, such as a person with cancer.
Kripalu Center for Yoga and Health
Lenox, MA 02140
The Kripalu Center for Yoga and Health was founded by Yogi Amrit Desai in 1971 and currently has a residential staff of 350 people serving 12,000 guests a year. Kripalu is situated in a wooded country setting and offers, in addition to its programs, vegetarian meals and spa facilities.
Kripalu has a full schedule of workshops and programs of varying lengths, most from 3 to 14 days in length. These are described in detail in The Kripalu Experience, a program guide issued twice yearly. Subjects range from 3-day program like “Gentle Yoga,” “Women and Yoga,” and “Relationships that Work” to “The Art of Stress-Free Living” and a more intensive meditation retreat lasting 1 week. The cost of a 3-day program ranges from $240 for the dormitory to $540 for deluxe accommodations. Six-day programs range from $465 for the dormitory to $1,035 for deluxe lodgings.
Kripalu also offers a less structured “Rest and Renewal” program, where you may come and create your own schedule from among a number of possible activities, including stretches and postures, meditation sessions, videos, workshops, and use of the Kripalu facilities.
Teachers of kripalu yoga can also be found in many areas of the country. This is a very gentle style of hatha yoga, quite easy for beginners, though teachers of more rigorous forms can also be found. Classes last approximately 1 hour and include postures, guided relaxation, and breathing practices. Kripalu Center can refer you to a teacher in your area.
(See chapter 19 for a discussion of qi gong.)
Qi Gong is a psychophysiological discipline like yoga or tai chi. The aim of qi gong is to reestablish the flow of chi (energy) which revitalizes the body and all of its systems. It is a component of traditional Chinese medicine widely used in China as an adjunct to mainstream cancer treatment. It has gained increasing popularity in the United States.
Qi gong instructors range along a relatively wide spectrum of practice, from a highly pragmatic, no-frills, contemporary approach to a more metaphysical, ritualistic, or “religious” one. The choice you make along this range is a matter of personal taste.
The practitioners of traditional Chinese medicine at the Pine Street Benevolent Society in San Anselmo, California, suggest that a competent instructor should have at least 10 years’ experience as a qi gong practitioner. Individuals who have had many years’ experience in the practice of tai chi or internal martial arts may have practiced qi gong for a shorter time, but may nevertheless be quite skilled as instructors.
Other cancer patients are probably the best resources for locating qi gong instructors. Practitioners of traditional Chinese medicine in your community would also be able to make referrals.
Most traditional medicines can be used in conjunction with mainstream therapies with no ill effects. If you are undergoing any mainstream therapies, be sure to check with both your doctor and a traditional practitioner about the possibility of any conflicts in the treatments.
Traditional Chinese Medicine
(See chapter 19 for a discussion of traditional Chinese medicine.)
It is not difficult to find practitioners of traditional Chinese medicine in most parts of the United States. The easiest way to locate the practitioners in your community is to look under “Acupuncture” in the Yellow Pages. Cancer support groups are also an excellent resource for finding referrals to acupuncturists who treat cancer patients.
The challenge is to find a practitioner who knows his craft well. The practitioners at the Pine Street Chinese Benevolent Association in San Anselmo, California, have developed a series of guidelines for cancer patients who are looking for capable acupuncturists. These are:
Credentials and licensing examinations: The most reliable indication that a practitioner of Chinese medicine has attained an acceptable level of training is possession of a license granted by the state of California, which has very rigorous entrance requirements. Practi-tioners from all over the world travel to California to take the examination. Other states vary considerably in the standards they set for licensing. The National Commission for the Certification of Acupuncturists (NCCA) is also a very prestigious credential.
Location of training: There are acupuncture schools in many parts of the United States. “Certified” schools are those that have qualified their programs to meet the standards of the state of California or the NCCA. Most Chinese, Japanese, and Korean practi-tioners have received fairly high levels of training in those countries. Most European schools that lead to the state of California license or NCCA certification have credible programs. Chinese or Hong Kong 3-month courses or various workshop trainings tend to be inadequate. This is also true for physicians who have taken a “short course” program.
Experience: Inquire about the length of time the practitioner has been in full-time practice. “Full-time” is minimally defined as 500 patient visits per year. Look for a practitioner who has had at least 5 years of full-time practice.
Scope of practice: A general practice of traditional Chinese medicine should include acupuncture techniques, herbal remedies, complementary supplements, general nutritional guidelines, general exercise guidelines, and general stress management guidelines.
Experience with cancer: The practitioner should have treated a minimum of 100 cancer patients and should have experience with your type of cancer as well–5 to 15 cases for unusual cancers and at least 25 cases for more common types. The practitioner should also provide you with patient contacts.
The acupuncturist or herbalist you choose should also be familiar with Western medical protocols so that he does not prescribe a treatment that contradicts your primary program (e.g., antioxidants that will interfere with radiation treatments).
Other interview questions: How does the practitioner assess the success of treatment? What criteria are used for this assessment? How accessible is the practitioner both for office visits and phone consultations? What kind of sterile procedures are used? What is the fee structure? Is there a sliding scale? If not, the first visit might range from $40 to $100 (the latter is justified if the intake interview lasts at least an hour and the practitioner has an hour of research and preparation before the next visit). Subsequent visits may range from $20 to $50.
Ayurveda is one of the principle traditional medicines of India, which has in modern times been only partially eclipsed there by Western medicine. Ayurveda arose from the same ancient tradition that gave birth to yoga. Deepak Chopra, M.D., an eloquent practitioner of Ayurveda,9 describes the ancient practice as follows:
The ancient doctors of India were also great sages, and their cardinal belief was that the body is created out of consciousness. A great yogi or swami would believe the same thing. Therefore, theirs was a medicine of consciousness, and their way of treating disease pierced the body’s matter and went deeper, into the core of mind. When you look at Ayurveda’s anatomical charts, you don’t see the familiar organs pictured in Gray’s Anatomy, but a hidden diagram of where the mind is flowing as it creates the body. This flow is what Ayurveda treats.10
Dr. Vasant Lad, Director of the Ayurvedic Institute in Albuquerque, New Mexico, and author of Ayurveda: The Science of Self-Healing, explains the process of healing according to Ayurveda:
Throughout life, there is a ceaseless interaction between the internal and external environment. The external environment comprises the cosmic forces (macrocosm), while the internal forces (microcosm) are governed by the principles of [the three elements]. A basic principle of healing in Ayurveda holds that one may create balance in the internal forces working in the individual by altering diet and habits of living to counteract changes in his external environment.11
A practitioner of Ayurveda uses various diagnostic techniques, such as examination of the pulse, tongue, face, lips, nails, and eyes to monitor the disease process, which is, in turn, a reflection of an imbalance among the three basic principles.
The maintenance of a diet compatible with the individual constitution is considered of basic importance to the recovery and maintenance of health. Yoga, breathing practices, and meditation are also employed in a therapeutic program, as are herbal preparations. Other components of a treatment program may be emotional release (the recognition, understanding, and release of negative emotions), therapeutic vomiting, and the use of purgatives, enemas, and fasting.12
Unlike Chinese medicine, Ayurveda is not recognized in the United States as a licensed treatment modality. Various training programs in Ayurveda do exist in the United States, but state laws vary as to whether practitioners can use their training to treat patients. The names and locations of some of the Ayurvedic practitioners in the United States who have received classic training in Ayurveda in India can be obtained through Dr. Lad’s Ayurvedic Institute (505-291-9698).
According to homeopathic educator Dana Ullman, M.P.H., homeopathy “is a natural pharmaceutical science that utilizes extremely small doses of substances to stimulate a person’s immune and defence system. Each medicine is individually prescribed according to the `law of similars’–that is, a substance which creates in overdose a specific set of symptoms in a healthy person will cure these similar symptoms in a sick person when given in very small doses.” Homeopathy is largely dismissed by Western medicine, although it is widely practiced in Europe and India. Some rigorous scientific studies supportive of homeopathic principles have been conducted, but none with cancer that I am aware of.
Ullman is director of Homeopathic Educational Services, 2124 Kitteredge Street, Berkeley, CA 94704, 510-649-0294, which is a mail-order source of information and educational materials on homeopathy and homeopathic products for health professionals and the general public.
The National Center for Homeopathy, 801 North Fairfax Street, Alexandria, VAê22314, 703-548-7790, fax: 703-548-7792, issues an annual directory of homeopathic practitioners, study groups, pharmacies, and resources.
American Cancer Society List of Unproven Methods of Cancer Treatment
The ACS maintains a list of unproven methods of cancer treatment and monographs describing these therapies and the centers that offer them. The list can be obtained by calling your local ACS office. The NCI also provides information about specific unproven methods, and this can be obtained by calling the hot line at 1-800-4-CANCER.
Basically, the list of unproven methods represents the best effort of the ACS to deal with the problem of unconventional cancer treatments. The list has been criticized both by advocates of alternative cancer therapies and by mainstream researchers and policy specialists on the grounds that it fails to differentiate between some of the more bizarre therapies and some interesting therapies that have not come up through the standard mainstream credentialing process.
It is also worth comparing the unproven methods list with the accounts of unconventional cancer treatments contained in the Office of Technology Assessment (OTA) report, Unconventional Cancer Treatments.13 The OTA report is widely regarded as providing a much more sophisticated analysis of these therapies.
According to the ACS, in many cases “unproven methods of cancer treatment” have some or all of the following characteristics:
1. They tend to be isolated from established scientific facilities and associations.
2. They often do not use regular channels of scientific and clinical communications.
3. They claim the established medical and scientific organizations, political and governmental agencies have conspired against them.
4. Their clinical and scientific records are weak and sometimes nonexistent.
5. They sometimes discourage or refuse consultation with reputable physicians or scientists.
6. Their treatments are sometimes secrets, or secretly prepared.
7. They sometimes discount biopsy verification in cancer diagnosis.
8. They may have multiple, unusual degrees from obscure institutions of higher learning or even correspondence schools.
9. Their chief supporters tend to be prominent statesmen, actors, writers, lawyers, even members of state and local legislatures–persons not trained or experienced in the natural history of cancer, in the care of patients with cancer, or with accepted scientific procedures and methods.
The ACS ranks unproven methods according to how effective the method is; how likely the method is to cause harm to the patient; and how much the method is used. According to these criteria, the unproven methods of “highest concern” are: antineoplastons (Stanislaw Burzynski’s therapy; see chapter 21); the Committee for Freedom of Choice in Medicine, Inc.; the Contreras method; the Greek cancer cure of Hariton Alivizatos; Immuno-Augmentative Therapy; laetrile; Livingston therapy (see chapter 16); macrobiotic diet (see chapter 15 and the Kushi Institute and Vega Study Center in section VIII, above); the National Health Federation; the Revici method (see chapter 23); and the techniques of O. Carl Simonton (see chapter 10).
“Of high concern” are dimethyl sulfoxide (DMSO); the Gerson diet (see chapter 14); Hoxsey herbs (see Bio-Medical Center below); the International Association of Cancer Victors and Friends, Inc.; Iscador (see below); Dr. Kelley’s nutritional and metabolic therapy (see Unconventional Nutritional Programs, above); live cell therapy; the metabolic therapy of Dr. Harold Manner; and psychic surgery. “Of concern” are Vlastimil Brych; electronic devices; and chaparral tea.
Probably the most striking current anomaly on this list, even accepting the controversial assumptions of the ACS, is the inclusion of O. Carl Simonton’s psychological imagery techniques in the category of “highest concern.”
Alternative and Complementary Treatment Centers: United States, Canada, Mexico, Bahamas, Britain, and Europe
This resource section does not attempt to provide a comprehensive list of alternative cancer treatment centers. The reader interested in a wider list and fuller descriptions can consult three documents: the ACS list of “unproven methods of cancer treatment” described above; the OTA report, Unconventional Cancer Treatments; and the valuable resource book by John Fink, Third Opinion,14 which describes most of the leading unconventional cancer treatment techniques used by American cancer patients today. Fink is generally supportive of these treatments; the ACS is generally critical; and the OTA report is somewhere between the two. Ralph Moss’s Cancer Therapy15 and Richard Walters’ Options16 are also valuable, generally pro-alternative sources of information on these therapies.
Livingston Foundation Medical Center
3232 Duke Street
San Diego, CA 92110
(See chapter 16 for a discussion of the work of Virginia Livingston.)
The Livingston Foundation Medical Center was established in 1971 by Dr. Virginia Livingston. The clinic provides immunological treatments based on the models developed by Dr. Livingston, including vaccines, diet and nutrition, supplements, psychological counseling, detoxification, antibiotics, and conventional drug therapies (as long as the latter are seen as consistent with the goal of immune enhancement).
The Livingston Foundation Medical Center offers two programs for patients. The first is a 10-day clinical immunotherapy program designed for patients suffering from an advanced debilitating illness. The second is a 2-day annual diagnostic program designed to evaluate the status of a patient’s immune system. The latter program is designed for persons who wish to use these techniques to maintain optimal health, for persons with chronic health problems, or for those who have a strong family history of immunodeficiency conditions. This program involves vaccines, diet, and lifestyle changes.
The 10-day program provides the basis for selecting and implementing an immunotherapy regimen which will be continued by the patient at home. Upon arrival, all patients are interviewed by a staff physician and a comprehensive medical history is compiled, including a family history record. The interview is followed by a complete physical examination using conventional diagnostic techniques. Selective diagnostic tests are then used to evaluate the status of the patient’s immune system and to identify any underlying microbial or bacterial infections. If the immune system is found to be inadequate by these measures, an immune enhancement program may be initiated. This might involve the administration of one or more vaccines, antibiotics, and antibodies (such as gamma globulin), as well as stimulation and restoration of liver function, detoxification, dietary adjustment, and nutrient supplementation.
Patients and family members are instructed in the administration of the various immunological therapies, nutrition planning and meal preparation, use of supplementary immune enhancement techniques, and detoxification procedures to be used by the patient after leaving the clinic.
The medical center also offers group and individual counseling designed to help individuals and families cope with the stress of illness. Visualization and stress reduction techniques believed to enhance immune response are also taught to patients.
In addition to cancer, the medical center treats patients with other potentially life-threatening diseases such as lupus, arthritis, and scleroderma. The clinic operates on an outpatient basis only.
The cost of the 10-day program is approximately $5,500. A deposit of $2,500 must be made in advance and the balance must be paid at the time of checkout. Additionally, laboratory work sent outside typically costs $500 to $800. The medical center estimates that the average patient pays between $600 and $1,000 per month for an ongoing program at home during the first year.
The 2-day prevention program requires an initial deposit of $600 toward the total cost of approximately $1,200, which must be paid in full upon completion of the program.
Institute of Applied Biology
26 East 36th Street
New York, NY 10015
(See chapter 23 for a discussion of the work of Emanuel Revici.)
According to patient literature supplied by Dr. Revici’s office, all substances administered as part of Dr. Revici’s therapies are “carefully and thoroughly demonstrated to be non-toxic. Therefore patients under his care suffer no significant adverse reactions from his medications. This general lack of toxicity permits Dr. Revici to administer his medicines in doses much higher than ordinarily used, sparing healthy cells and the immune system from harm.”
An initial consultation with Dr. Revici costs $200 (paid by traveler’s check or money order), and the patient must bring all previous pathology reports with diagnoses, results of any current laboratory tests, x-ray films, computed tomography (CT) scans, and magnetic resonance imaging (MRI) tests. The patient must also bring the names of current medications being taken currently and a history of previous therapies for the cancer.
Follow-up consultations with Dr. Revici are $95 and injections of medications are $50. Fees for laboratory tests are billed directly to the patient.
Dr. Revici stresses that the best results are obtained with his therapy when he has sufficient information to guide the therapy individually so that dosages can be adjusted and medications altered when necessary. Therefore, his office recommends that all patients participate in the chronic disease management program, run by Dr. Bijan Khoshbin, to provide regular and close monitoring of symptoms and the effects of medications. The charge for this service is $150 per month and includes physical examinations, urine analysis, adjuvant nutritional treatment, prescription of diagnostic tests, and referrals to specialists when necessary. This fee and service are separate from any charged by Dr. Revici for his services.
Nicholas Gonzalez, M.D.
737 Park Avenue
New York, NY 10021
(See Unconventional Nutritional Programs, above for a description.)
Burzynski Research Institute
6221 Corporate Drive
Houston, TX 77036
(See chapter 21 for a discussion of the work of Stanislaw Burzynski.)
All patients visiting the Burzynski Research Institute are treated on an outpatient basis. The treatment is self-administered and, according to the institute, usually free of side effects. Dr. Burzynski also believes that the treatment does not interfere with surgery, radiation therapy, or most chemotherapies and immunotherapies. In some cases, small doses of conventional chemotherapy or immunotherapy agents are used along with the antineoplaston treatments.
At the time of initial contact, a detailed medical history is taken over the phone, and after a review of the patient’s history, one of the medical staff calls the patient to discuss whether or not the treatment may be of help.
Patients are monitored closely during the first 2 weeks of treatment, with appointments typically scheduled twice weekly during this period. After the initial 2-week stay, follow-up visits are scheduled every 4 to 8 weeks. Follow-up visits average 2 to 5 days in length.
Initial patient response is evaluated by standard medical tests, usually within the first 3 to 6 weeks of treatment. At a minimum, treatment usually lasts 4 months to 1 year.
For most patients, the fee for antineoplaston treatments range from $135 to $315 per day. The initial consultation with Dr. Burzynski, without treatment, is $125. Follow-up appointments are $60. Other expenses include the usual diagnostic tests (radiographs, CT scans, MRI) and standard blood and urine tests which are used to monitor the patient’s progress. If intravenous administration of the therapy is necessary, additional supplies must be procured outside the clinic at a cost of $4,200 to $6,300.
An initial deposit of $5,000 is required from all patients prior to the start of treatment. For patients receiving antineoplaston therapy intravenously, a monthly deposit of $2,500 is charged beginning with the second month of treatment. For patients taking capsules, no further payments are required until the tenth month of treatment, when an additional $5,000 deposit is made.
After the first week of treatment, the institute begins filing insurance claims to the patient’s insurance carrier. If insurance payments are forthcoming, the patient does not have to make further monthly payments, and the $5,000 deposit is refunded once insurance has paid the entire bill.
Accommodations in nearby furnished apartment complexes can be arranged in advance through the clinic.
Mexican alternative cancer treatment centers all operate in a frontier cultural context that defies easy description. To some people, the treatments at these centers appear to be the quintessence of cancer quackery and sleaze. To others, the operators of these centers are folk heroes and courageous cancer treatment pioneers. You pay your money (often a lot of money) and take your choice.
If you are considering treatment in Mexico, you would be well advised to travel to the Tijuana area and spend some time visiting the clinics that interest you and talking to patients about their experiences before signing up for treatment. There are motels and trailer parks just north of the border on the American side where many cancer patients live while undergoing treatment. The grapevine there about what is happening at the clinics is strong and well-informed.
PO Box 727
Tijuana, B.C., Mexico
The Bio-Medical Center is one of the best-known Tijuana cancer clinics. It is an outpatient clinic that treats all types of malignancies using the Hoxsey therapy, immunotherapy, chemotherapy (in serious cases), homeopathy, and chelation therapy.17 The treatment also includes supplements and dietary restrictions. The Hoxsey therapy has long been regarded as an archetype of cancer quackery by the American Medical Association and the ACS.
The legend is that the origins of the Hoxsey therapy date back 150 years to veterinarian John Hoxsey who observed a horse cure its cancer by eating certain wild plants in the pasture. Hoxsey gathered these herbs, added ingredients from home remedies for cancer, and successfully treated other animals with cancer. His descendants used the same preparation to treat cancer in humans.18 Hoxsey did not claim to know how or why the treatment worked.19
The OTA, in its evaluation of the Hoxsey therapy, reports:
The data indicate that many of the herbs used in the Hoxsey internal tonic or the isolated components of these herbs have antitumor activity or cytotoxic effects in animal test systems. The complete Hoxsey herbal mixture has not been tested for antitumor activity in animal test systems, with human cells in culture, or in clinical trials, however. It is unknown whether the individual herbs or their components that show antitumor activity in animals are active in humans when given in the concentrations used in the Hoxsey tonic. It is also unknown whether there might be synergistic effects of the herbs used together.20
Initial x-ray films and examination run from $250 to $450. The cost of the Hoxsey therapy itself, for as long as it is necessary, is $3,500. A down payment of at least 30% must be paid on the first visit. (The clinic claims that inability to pay does not prevent a patient from receiving therapy.)
American Biologics-Mexico S.A. Hospital and Medical Center
United States Admissions Office
1180 Walnut Avenue
Chula Vista, CA 92011
Tel: 619-429-8200 or 1-800-227-4458
Clinic: 15 Azucenas Street, Tijuana, B.C., Mexico
American Biologics-Mexico is one of the most efficiently operated of the Mexican alternative cancer treatment centers. Its founder, Robert Bradford, is a long-time veteran of the alternative cancer therapy wars and an accomplished businessman who knows his product (alternative cancer therapies) and his clients. Bradford offers one of the broadest lines of alternative therapies available in any Mexican clinic, with one of the most polished presentations of his product.
Although American Biologics-Mexico treats all kinds of cancer, the staff claims that adenocarcinomas of the lung, colon, and breast are their best overall responders. The staff claims also that they do well with leukemias, lymphomas, and localized sarcomas. They report that extensive liver metastases and pancreatic cancer are their most difficult cases.
American Biologics-Mexico claims symptom-free or mostly symptom-free 5-year survivals in roughly 20% of their cases. They do not promise to “cure” cancer. Writing in their literature, Michael Culbert, Vice-President of American Biologics-Mexico, states, “Our maximum claim is that, under the best of conditions, we will place cancer under `control’ so that a patient may live out his/her appointed genetic lifespan without cancer being a major problem.”
American Biologics-Mexico implements individualized, integrated metabolic and eclectic programs developed by its sister organization, the Bradford Research Institute. American Biologics-Mexico offers a comprehensive range of services. According to Culbert, “Our sole interest is in the disease-free survival of the patient, not the proving of a concept or theory. To this end, we may use any combination of vitamins, minerals, enzymes, amino acids, endocrine balancing, immune enhancement, gastrointestinal detoxification, alkaline diet, herbs, oxidative therapies, and even antibiotics, chemotherapy, surgery or low-grade radiation or synthetic hormones.” American Biologics-Mexico also offers “live-cell” therapies.
American Biologics-Mexico S.A. Medical Center and Hospital describes itself as a fully accredited and licensed general hospital and teaching facility. Both in- and outpatient services are available; there are beds for a maximum of 27 inpatients and the clinic can serve approximately 40 outpatients per day.
Prices range from $1,900 for 1 week for outpatients to $4,500 per week for inpatients with private rooms. The average stay is between 3 and 4 weeks.
Hospital Ernesto Contreras
P.O. Box 43-9045
San Ysidro, CA 92143-9045
Tel: 1-800 326-1850 or 1-800 LAETRYL
Hospital: Paseo Playas de Tijuana No. 19, Playas de Tijuana, B.C. 22700, Mexico
The Hospital Ernesto Contreras is one of the oldest unconventional cancer therapy centers in Tijuana. Dr. Ernesto Contreras, Sr., was among the first practitioners to offer laetrile as a treatment for cancer.
Contreras reports that his hospital treats about 1,000 patients a year, 80% of whom are considered advanced or terminal cases. The hospital treats all kinds of cancers. Contreras claims a subjective response rate among hospital patients of 65% and an objective response rate of 35% (i.e., cases in which the tumor has decreased in size by at least 50%).
Contreras and his staff believe that cancer is a systemic rather than localized disease, calling for a three-pronged emotional, spiritual, and physical approach. The hospital offers a varied metabolic therapy, including amygdalin (laetrile), detoxification, proteolytic enzymes, nutritional regimen, intravenous amino acid and vitamin solutions, high-dose vitamin C, and oxygen, for most carcinomas and lymphomas.
For primary brain tumors and sarcomas, the hospital utilizes the Alivett treatment, “a process which kills the abnormal cells and inhibits their reproductive rate while selectively feeding normal cells to re-establish their normal reproductive rates. … Inasmuch as the ingredients of the treatment are found in the human cell, the resultant product is non-toxic even when administered in quantities well above those recommended.” The treatment consists of a series of injections (normally 20) administered daily.
The Warburg therapy, which is known in the United States as the Cone cancer therapy system, is employed for tumors of the head and neck, pulmonary metastases, myelomas, and any other tumors resistant to the treatments described above. This therapy is considered experimental in the United States, but may be available by patient request with informed consent. The therapy consists of a low fat, high carbohydrate nutritional regimen and three nontoxic medications–Lente insulin (an insulin zinc preparation), quercetin, and thyroid hormone. In theory, these components combine to starve tumor cells and boost acidity to lethal levels within the targeted cells.
Immusyn C is also available at the Hospital. According to hospital literature, Immusyn C is a chemotherapeutic agent selectively toxic only to cancer cells that can be used alone or in combination with other chemotherapies or radiation. 714-X, the therapy developed by Gaston Naessens in Canada, is also available at Hospital Ernesto Contreras.
In addition to the 50-bed, standard hospital facilities on the first floor, Hospital Ernesto Contreras maintains 20 motel rooms on the second floor. Outpatients are encouraged to stay at the International Motor Inn in San Ysidro on the U.S. side of the border. The hospital provides frequent van service to the facility.
The average stay is 3 weeks. The cost typically ranges from $8,500 to $10,000 including meals and lodging for both patient and a companion. Costs for patients receiving either the Alivett or Warburg therapies on an outpatient basis may be slightly less. A minimum $6,500 deposit is required upon initiation of services, with the balance due on departure.
Take-home medications typically cost $1,500 to $2,000. Surgical procedures, chemotherapy, radiation, and antibiotics are charged separately.
Centro Hospitalario del Pacifico S.A.
Playas de Tijuana, B.C., Mexico and the Gerson Institute
PO Box 430
Bonita, CA 91908
(See chapter 14 for a discussion of the Gerson therapy.)
The Gerson Institute in Bonita, California is associated with the Centro Hospitalario del Pacifico S.A. (CHIPSA) in Tijuana, which offers the Gerson program. Some patients like the experience at CHIPSA and others do not. Like most of the Mexican cancer clinics, the program experiences changes with time and personnel changes. If you are considering participating in the program, it is certainly worth visiting the hospital and talking with patients before signing up.
CHIPSA recommends a minimum initial stay of 21 days, and 4 to 6 weeks for more seriously ill patients. The hospital requires a deposit of $3,990 at the time of admission, and a $3,990 deposit in advance for each subsequent week. Additional charges may be incurred, especially by patients who are very ill. Companions pay $308 per week, which includes room and board and training in the Gerson therapy.
After leaving the hospital, the therapy is continued at home for upward of 18 months with periodic adjustments. This regimen consists of a vegan diet (plant products only), juices taken hourly, and detoxification. Once a routine is established, the patient can usually leave home two times each day for 5 hours, though an extended lunch period is required. A 3-month supply of Gerson medications costs $550 (not including adjuvant medications) and a juicer costs a minimum of $240. Specialized food requirements may entail substantially higher costs (from $200 to $500 per week) and much greater efforts to obtain needed items.
Rock Forest, Quebec, J1N 3B6, Canada
Gaston Naessens, a French-born biologist, utilizes an apparently powerful microscope of his own invention, called the “Somatoscope,” to examine live blood for the purpose of diagnosing cancer and monitoring treatment.
Naessens theorizes that harmless microorganisms arising within the body could, under some conditions, become lethal. This theory places him in the tradition of researchers whose work has been eclipsed by Pasteur’s belief that organisms originating outside the body were responsible for disease. Naessens’ theory is parallel to that of the late Virginia Livingston (see chapter 15) and other exponents of the existence of entities called “cell wall-deficient bacteria” said to play a role in cancer and other diseases.
Using the Somatoscope, Naessens believes that he is able to view the cycle of the “somatid,” a pleomorphic (form-changing) organism in the blood which is “a transitional link between matter and cosmic energy. It may well be the first manifestation of life.” In people with fully functional immune systems, the somatid cycle consists of three stages, whereas an impending diseased state is indicated by the presence of successive 13-stage cycles.21
In the literature describing his therapy, Naessens states that healthy bodies develop and fight off small cancers regularly, but that a deficient immune system allows the cancer to reach a critical point where it withdraws nitrogen from the body for its own use, and in the process paralyzes the immune system. Naessens utilizes a camphor derivative called 714X which reportedly inhibits the formation of the substance produced by the tumor that makes nitrogen available to the tumor and suppresses the immune system.
According to the clinic, it is not necessary to have the results of a blood test initially when giving 714X. However, a fresh blood test is recommended after 3 months in order to evaluate the success of the treatment. Few practitioners have the necessary equipment to accomplish this, but the clinic can supply the names of those who do.
714X is said to be nontoxic and to have no known side effects. It is injected daily into the lymph nodes (preferably in the groin). In average cases, three series of 21 injections are required, each followed by a “booster shot.” It is recommended that the patient continue the treatment until no more signs of the disease are present.
A quantity of 714X sufficient for one series of injections (21 days) costs $300. The protocol and injection instructions are included with the shipment. Payment must be accompanied by a medical prescription.
Immuno-Augmentative Therapy Centre, Ltd.
PO Box F-2689
Freeport, Grand Bahama
Immuno-Augmentative Therapy (IAT) was developed by the late Lawrence Burton, Ph.D., and has been used with patients at his Bahama center since 1977. The IAT Centre remains open after his death. IAT is one of the best-known and controversial unconventional treatments for cancer. The effort to evaluate the effectiveness of IAT was the original impetus behind the OTA’s Unconventional Cancer Treatments report. The OTA was unsuccessful in its effort to reach agreement with Burton on an objective assessment of his therapy. Burton kept key elements of his therapy a proprietary secret. His critics believe his therapy is pure quackery; his supporters believe it is pure genius, and patients keep coming to fill his Bahamian treatment center.
The IAT literature describes the reported theoretical basis of the treatment:
During the 1960’s, Lawrence Burton, Ph.D., with a team of scientific and medical investigators, pursued a means to reduce or inhibit tumor growth. An accepted assumption was that animals have one or more components in their blood which control mitosis (cell division) and growth … and, therefore, there existed an anti-cancer immune defense mechanism. They further assumed that a balanced proportion of these components results in normal mitosis and cellular growth, but an imbalance may result in malignant neoplasms. They believed, too that these components could be isolated without deactivating them. … Their hypothesis indicated that administration of such growth components … would cause the host’s natural immune defense mechanism to function, and result in reduction and/or remission of neoplastic tissue [emphasis in original].22
The treatment regimen is based on reported assessment of the patient’s immunocompetence. The patient’s blood is then tested twice daily for the relative concentration of four basic factors. Patients inject themselves daily with processed blood products to maintain the proper balance of these factors. The dose levels are determined by a proprietary computer system which is also used to monitor results and project necessary dosages once patients leave the center. The self-injection protocol continues at home indefinitely.23
All IAT patients must be accompanied by an adult companion. The center is an outpatient facility, so patients must stay in local hotels or apartments that have kitchen facilities. Patients stay an average of 12 weeks in Freeport.
Four weeks of therapy cost $5,000, and thereafter the cost per week is $500. This fee includes all routine tests, services, and other components of the therapy. The cost of the home maintenance prescription is $50 per week.
CH-4144 Arlesheim, Switzerland
(See chapter 3 for a discussion of anthroposophical medicine.)
The Lukas Klinik is perhaps the most beautiful cancer hospital I have visited in my travels. Founded by followers of the anthroposophical thinker Rudolf Steiner, I found it to have a deep aesthetic appeal. The clinic uses mainstream therapies in combination with anthroposophical therapies including vegetarian diet, movement therapy, color therapy, art therapy, speech therapy, herbal therapy (including Iscador; see section XIII, below), and special baths. The disadvantage of the clinic for Americans, at least at the time of my visit, was that most staff did not speak English and most discussion was in Swiss German. For German-speaking cancer patients with a proclivity toward the anthroposophical spiritual tradition, the Lukas Klinik is well worth exploring.
Hans A. Nieper, Dr. med.
Paracelsus Klinik at Silbersee
3012 Langenhagen, Germany
Hans Nieper is a controversial German alternative cancer therapist who receives mixed reviews from American cancer patients who visit him. His therapies for cancer are based on “the principle of assisting the body’s own defense mechanisms, which exist in every human being.” He postulates that in the 40% of the population whose defenses are not sufficiently strong to ward off cancer, it is important to strengthen the immune system as a preventive measure through a diet containing large amounts of carotene, selenium, vitamins C and D2, magnesium, and molybdenum. In cases of existing cancer, these substances can be utilized along with others, such as bromelain–an enzyme obtained from pineapple–to combat the cancer. The latter is one of a number of enzymes used to “deshield” the tumor cell membrane and to “deblind” immune cells so that the tumor becomes susceptible to action by the immune system.
Dr. Nieper uses radiotherapy and chemotherapy only for short-term alleviation, since he believes that these are injurious to the body and do not address the underlying cause of the cancer, the deficient immune system.
A number of methods are claimed to restore the immune system, depending upon the point in the system where the disturbance lies. One of the therapies Dr. Nieper uses to restore immune function is “desodification” (elimination of sodium) “By this method, cancer cells are `detoxified’ from the inside. Which method is actually applied depends on the clinical picture of the individual patient. However, the basic principle is always the administration of certain natural substances which do not destroy but which restore.”24 Nieper also uses BCG (bacille Calmette-Guérin), Wobe-Mugos enzymes, and laetrile in his therapy.
In addition, Nieper uses a “gene repair” therapy which is based on his theory that “gene `instabilities’ (not true mutations) may play a pivotally important role in cancer. The elimination of such gene instabilities seems feasible. This would then result in a normalization (or re-differentiation) of the cancer cell–or its elimination. Starting from investigation of so-called anti-cancer surveillance steroids to which belong Tumosterone and DHEA [dehydroepiandrosterone], Dr. Nieper introduced plant-derived gene surveillance substances into the clinical management of cancer.”25
Patients normally remain at the hospital for 9 to 21 days. Fees for inpatient therapy normally range from DM 450 to 550 per day, including all doctors’ fees and treatment costs.26
Robert Janker Klinick
Fachklinik für Tumorerkrankungen
5300 Bonn 1, Germany
The Janker Klinik is one of the most popular German cancer clinics for American cancer patients seeking an “unconventional/conventional” treatment outside the United States. It is strongly recommended by writer-researcher Patrick McGrady (see section I, under Consultants for Mainstream and Complementary Therapies, above). The program makes use of intensive chemotherapies and other protocols not available in the United States.
Bristol Cancer Help Centre
Clifton, Bristol BS8 4PG, England, United Kingdom
Since its founding in 1980, the Bristol Cancer Help Centre has been a pioneer in the development of psychosocial support programs for people with cancer. According to the center’s description of its work, “Our approach is not an alternative to medical treatment. The holistic model promoted at Bristol is patient-centered, targeting the disease at the level of the body, mind and spirit. Counseling, group sessions, meditation, visualization, and a range of creative therapies are used to help individuals develop their own resources to cope with threats to quality of life and potential recovery.”
The Bristol Centre offers an “Introductory Day” which can be complete in itself, but they strongly recommend that patients continue with the weeklong “Residential Course” and subsequent “Follow Up Days.” All programs are led and supervised by physicians with support by therapists and other staff members. The center also recommends that spouses, support people, and caregivers attend along with the patient.
In the residential course, group support, meditation, visualization, and self-help techniques are employed to help patients in adjusting to the experience of cancer and cancer treatment. Patients are assisted in assessing their own needs, establishing personal goals, setting up a network of support, and creating a self-help program. They also learn about holistic medicine and its possible effect on the course of the disease.
The cost of the residential course is £350, although the center states that its policy is that no one be denied a place because of lack of funds.
Alternative Pharmaceutical Treatments
(See chapter 22 for a full description.)
Hydrazine sulfate is an inexpensive drug of mild toxicity that studies have shown can, in some cases, enhance the nutritional status of cancer patients and help them avoid weight loss–thus possibly extending life. In the United States, it is currently available to cancer patients through their physicians. The physician must obtain the substance through the FDA’s Investigational New Drug compassionate (IND) program. For information on obtaining hydrazine sulfate in this way, ask your physician to contact the Syracuse Cancer Research Institute Inc., Presidential Plaza, 600 East Genesee Street, Syracuse, NY 13202, 315-472-6616.
The compound is also sold through several of the Mexican clinics.
According to the Swiss Society for Oncology, Iscador is a fermented extract of mistletoe that was first proposed as a treatment for cancer in 1920 by Rudolph Steiner, the founder of anthroposophy. It is the most widely used unconventional pharmacological agent for the treatment of cancer in Europe. It is less widely used in the United States. Iscador is thought by proponents to have anticancer activity and to increase immune function. The toxicity of Iscador varies according to its preparation and method of administration, but in the hands of a knowledgeable practitioner it is relatively nontoxic. There is a considerable research literature on Iscador and related mistletoe products, some of it demonstrating antitumor activities or immunostimulation in experimental systems. I am not aware of any clinical studies showing significant antitumor activity in controlled human clinical trials.
According to Immaculada Marti, M.D., an anthroposophical physician at Davies Medical Center in San Francisco, Iscador is not available from sources in the United States, but must be obtained by a physician from European suppliers. In the anthroposophical tradition, Iscador is not used as an isolated pharmaceutical treatment, but is usually administered as part of a combination therapy along with other anthroposophical medicines, external therapies (such as baths), and movement therapies.
Dr. Marti is one of about 35 anthroposophical physicians practicing in the United States. She is able to provide patients and interested physicians with information about anthroposophical approaches to cancer care and to direct them to the nearest anthroposophical practitioner: call 415-565-6000. The Lukas Klinik (see Treatment Centers above) in Switzerland is the leading anthroposophical treatment center in the world and the source of much of the research on Iscador and other anthroposophical medicines.
Laetrile (also known as amygdalin) is a controversial cancer treatment found naturally in the seeds of apricots and other members of the Rosaceae family. Its use was fairly widespread in the mid-1970s, but it has become less sought-after as a cancer treatment since that time. According to the OTA report, Unventional Cancer Treatments:
Laetrile proponents claim that laetrile kills tumor cells selectively, while leaving normal cells alone. In support of this, Ernst Krebs, Jr. [one of the developers of laetrile], hypothesized that normal cells produce an enzyme, beta glucosidase, that breaks down laetrile, releasing cyanide, which is then converted by a second enzyme, rhodanese, to the less toxic thiocyanate molecule; cancer cells, however, lack the enzyme rhodanese, according to Kreb’s theory, and are therefore killed by free cyanide.27
In contrast to the early years of laetrile’s use, when claims for antitumor activity were made, proponents more recently have cited laetrile’s effectiveness as part of a wider metabolic regimen, including DMSO, vitamins, enzymes, and other substances.28 Many clinics in Mexico use laetrile in this way, including American Biologics-Mexico and Hospital Ernesto Contreras described above. Mainstream clinical trials of laetrile showed no significant antitumor activity, but these studies have been (predictably) criticized by proponents of laetrile on methodological grounds.29
According to the OTA report, the most common adverse side effects of laetrile ingestion are nausea, vomiting, headache, and dizziness. Laetrile itself is about 6% cyanide by weight and cyanide toxicity has been observed in people taking it. Lethal doses of cyanide can be reached if an excessive amount of laetrile is ingested or if something is done to accelerate the release of cyanide, such as eating foods high in the enzyme that promote this release (e.g., nuts, lettuce, celery, or mushrooms).30
The use of laetrile is illegal in many states. The Cancer Control Society (213-663-7801), an advocacy organization for alternative cancer therapies, can provide information about laetrile, lists of practitioners who prescribe it, and the circumstances under which it may be legally obtained.
Immuno-Augmentative Therapy Centre, Ltd.
Freeport, Grand Bahama
(See Immuno-Augmentative Therapy Centre above.)
Burzynski Research Institute
6221 Corporate Drive
Houston, TX 77036
(See chapter 21 for a discussion of the work of Stanislaw Burzynski; see Alternative and Complementary Treatment Centers above.)
Livingston Foundation Medical Center
3232 Duke Street
San Diego, CA 92110
(See chapter 16 for a discussion of the work of Virginia Livingston; see also Alternative and Complementary Treatment Centers: United States, Canada, Mexico, Bahamas, Britain, and Europe above).
Notes and References
1 David Zimmerman, “How Pat McGrady’s `Can Help’ Helps Patients with Cancer,” Probe: David Zimmerman’s Newsletter on Science, Media, Policy and Health, November 1, 1991.
2 Gerald G. Jampolsky, Love is Letting Go of Fear (New York: Bantam Books, 1970; Berkeley, CA: Celestial Arts Publishing Co., 1988).
3 Jon Kabat-Zinn, Full Catastrophe Living: Using the Wisdom of Your Body and Mind to Face Stress, Pain, and Illness (New York: Dell Publishing, 1990).
4 Bernie S. Siegel, M.D. Love, Medicine and Miracles (New York: Harper & Row, 1986; HarperCollins, 1990).
5 O. Carl Simonton, Stephanie Matthews-Simonton, and James Creighton, Getting Well Again (Los Angeles: Jeremy P. Tarcher, 1978).
6 Raychel and Mark Solomon, Coming Alive with Raychel (San Diego: Raymark Books, Inc., 1986).
7 Michael Hollingworth, “Everyday `Miracles'” Australian Wellbeing March/April 1986, 94.
9 Dr. Chopra is the author of several informative books on Ayurveda: Creating Health: Beyond Prevention, Toward Perfection (Boston: Houghton Mifflin Company, 1987); Return of the Rishi: A Doctor’s Search for the Ultimate Healer (Boston: Houghton Mifflin Company, 1988); and Quantum Healing: Exploring the Frontiers of Mind/Body Medicine (New York: Bantam Books, 1989).
10 Deepak Chopra, Quantum Healing: Exploring the Frontiers of Mind/Body Medicine (New York: Bantam Books, 1989).
11 Dr. Vasant Lad, Ayurveda: The Science of Self-Healing (Wilmont, Wis.: Lotus Press, 1984), 29.
12 Ibid., 52-68.
13 U.S. Congress Office of Technology Assessment. Unconventional Cancer Therapies (Washington, D.C.: Government Printing Office, September 1990).
14 John Fink with Sue Carlan, Third Opinion: A Guide to Alternative and Adjunctive Therapies, Clinics and Physicians in the Treatment and Prevention of Cancer, second edition (Garden City Park, NY: Avery Publishing Group, 1992).
15 Ralph W. Moss, Cancer Therapy: The Independant Consumer’s Guide to Non-Toxic Treatment and Prevention (New York: Equinox Press, 1992).
16 Richard Walters, Options: The Alternative Cancer Therapy Book (Garden City, NY: Avery Publishing Group Inc., 1993).
17 Bio-Medical Center literature.
18 Office of Technology Assessment, Unconventional Cancer Treatments, 75.
19 H.M. Hoxsey, You Don’t Have to Die (New York, NY: Milestone Books, 1956). Cited in Office of Technology Assessment, Unconventional Cancer Treatments, 76.
20 Office of Technology Assessment, Unconventional Cancer Treatments, 79.
21 Christopher Byrd, “Gaston Naessens’ Symposium on Somatidian Orthobiology: A Beachhead Established” Townsend Letter for Doctors October 1991:797-99.
22 Immuno-Augmentative Therapy Center literature.
23 Office of Technology Assessment, Unconventional Cancer Treatments, 131.
24 Dr. Hans Nieper, New Biological Therapies (Los Angeles: Paracelsus Hospital Corporation) p 7.
25 Ibid, 6.
26 John Fink, Third Opinion, 142.
27 Office of Technology Assessment, Unconventional Cancer Treatments, 103.
28 Ibid., 103.
29 Ibid., 106.
30 Ibid., 103.