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Click here to return to chowka.com Click here to return to or to read part one of this chapter from Evaluating Alternative Cancer Therapies Section Four
Peter Barry Chowka
Part Two of Two From Evaluating Alternative Cancer Therapies:
© By David J. Hess, Ph.D.
continued from part one
Therapeutic Preferences
Chowka began a discussion of this topic on a cautionary note by pointing out the complexities of seeking opinions from people about their therapeutic preferences. He expressed a concern that "many people who may become involved in the field of alternative cancer--not from the clinical end but from the advocacy point of view--ultimately wind up developing a vested interest in the business of what grows up around what they started out to do. So one of the questions for me in how I approach my writing or journalism is to try to get at an individual's bottom line or vested interests. That serves as well for clinicians." Chowka does not have financial links with any cancer therapy. He regards his main goal in this arena as providing better coverage of the issues and helping to spur more evaluation of alternative and complementary therapies, rather than making pronouncements on what seems to be more or less promising. Nevertheless, he is often asked for advice, and over the years he has developed some opinions on the various ACCTs that he was willing to share publicly. "Literally every day of the year I get at least one e-mail message, sometimes more, from people all over the world, who write, 'I've just been diagnosed with cancer,' or 'I've been told I'm terminal. What would you do or what can you recommend?' This question is always on my mind, and I am very cautious in answering it. Ultimately it's unanswerable because I can't put myself in somebody else's shoes. What has impressed me over the course of time is the necessity of each person taking the responsibility and matching their needs with the best clinical options possible. That's easier said than done. It’s a big responsibility.
"I tell people, 'If you want to take this path, there's not a lot you can rely on. Yes, there are services and information available that can help point the way, but ultimately you will have to cut through the B.S., the vested interests, and the agendas that everybody--including myself--has and find what works best for you. You can have access to the best therapy and the finest clinician, but if there isn't a meeting of the minds between the patient and the clinician, it isn't going to work. "Over the years I've spent many months at the Bio-Medical Center (the Hoxsey clinic) in Tijuana, Mexico, which is a very interesting environment for observing many of these hypotheses and how the whole process actually works. Mildred Nelson, R.N. has been the director of the clinic for forty years and has actively treated almost all the patients who came through the door. She is an innate healer, a master of the psychological approach. If she felt that a patient needed a firm approach, that's what she would offer him. If the patient was very sick, cowering, or scared, she would adopt a sensitive, Florence Nightingale persona, and that would work best for that patient. In other words, she matched up the therapist with the patient. On the other hand, some people went to the Hoxsey clinic and didn't like it. They wanted something more standard, more conventional, or more familiar, so they left and went elsewhere. You can’t please everyone. "Over time I've tried to understand why apparently opposing therapeutic approaches appear to work for different people. For example, why would macrobiotics work for one person and a raw foods diet help another, when, according to one, the other should not work at all? This gets into the area of not only the mindset of the patient, the match-up between his or her needs and the therapist's approach, but other subtle areas that are hard to quantify, like the role of the spirit in healing. It might even explain why some people can use chemotherapy and get well. Every once and a while I do hear of a case--rare as it might be--where someone has undergone a full, very aggressive course of chemotherapy, and actually survives and lives a very long life. Maybe it was primarily the person’s innate need, desire, and will on some unquantifiable level to get better that ultimately made the difference. I've had the opportunity to interview clinicians like Bernie Siegel, Carl Simonton, Stephanie Matthews-Simonton, Lawrence LeShan, and Larry Dossey--people working on the frontiers of mind-body medicine--and when I've been with every one of these people--particularly Dossey, Simonton, and Siegel--I felt like I was in the presence of someone on the very leading edge. These are extraordinary people, in touch with a kind of awareness that in this century conventional medicine has completely lost touch with or put aside. They're helping to put us back in contact with that traditional wisdom that helps to place everything into perspective, including the more purely mechanical aspects of what we might turn to clinically. "I see many people overlooked in discussions of alternative medicine, people like Abram Hoffer, M.D., Ph.D., whom I've had the opportunity to interview. I arranged for him to be a speaker at the AANP’s 1997 East Coast conference of naturopathic medicine, and he's an exceptional individual." Chowka also mentioned William Donald Kelley, D.D.S. "I have a tremendous amount of respect for Kelley. I interviewed him on a number of occasions. He made numerous contributions and yet he was a humble person, and a little humility goes a long way in this field. In fact that's one of the principal crieria of my own private way of evaluating people. I know that when I have health needs or needs in any area, I just feel more comfortable when I work with someone who's not on an ego trip." Chowka also mentioned James Privitera, M.D., as another example of one the underexposed pioneers of alternative and complementary cancer therapies. Privitera had been prosecuted for using laetrile during the late 1970s, and was pardoned by the former governor of California, Jerry Brown. Chowka is able to draw informally on his own experience to point to pockets of long-term survivors using specific alternative cancer therapies. Qualifying his observations as "highly anecdotal and subjective," Chowka commented, "For many years in the course of my work I did high-profile, in many instances national, call-in talk shows on the cancer issue, with hosts like Tom Snyder, Michael Jackson, Michael Reagan, Tom Leykis, Ray Briem, and so on. After writing an article for a publication I would go on a talk show to discuss it before a large, mainstream audience. (By the way, that was not because I was looking to cash in--talk shows don't pay guests and I'm not in this for the money anyway.)" Some of the programs had millions of listeners nation-wide and went on live for three or four hours. "I would get many, many calls from patients who said they had been treated successfully by William Donald Kelley or by the Hoxsey approach, some even by Harry Hoxsey himself, who left the scene in the late 1950s. These were not set-up calls because they were not shows that had a lot of advance publicity. I didn't call around beforehand and tell people to tune into the show. All of a sudden the show is on; I'm on as a guest; and there it is. This was pre-Internet; there was no way to publicize it. So I feet that the response I got from listeners was very legitimate vox populi: people coming out of the woodwork to say, 'Yeah, I saw Harry Hoxsey when he was in Dallas in 1950. This was the kind of cancer I had, and it was a confirmed diagnosis, and here I am, alive and well to this day decades later .' In my experience there are relatively few alternative cancer therapies like Hoxsey that have that number of people who can step forward at the drop of a hat to say unequivocally that it helped them. I conducted a small informal study of my own on the Hoxsey therapy in 1987-88. Mildred Nelson allowed me to have access to her files. I designed a questionnaire and sent it to the last known address of about 100 of her patients. Some of the patients were long dead because the files went back to the 1950s. About 35 people responded to the questionnaire, and many of their stories were truly amazing--grounds for further research, one might say." When I expressed surprise that he had not received many calls from patients of other long-established and well-known therapies such as those of Gerson and Revici, Chowka replied that one reason may be that at the time the Gerson clinic in Mexico did not have the facilities to treat large numbers of patients (nor had it been functioning for as long as the Hoxsey clinic). Chowka added that on programs broadcast in the New York area he did receive calls from Revici patients. Chowka also pointed out that when he visited Tijuana starting in 1979, some patients at one of the larger clinics complained to him not only about paying high fees but about being subjected to conventional therapies such as radiation, whereas he never heard complaints from patients at the Hoxsey clinic. "I'm not shilling for them; I'm not paid by them. But the Hoxsey clinic is so different from anything else I've ever seen." He went on to say, however, "I don't think there is a cure-all out there. There are definitely approaches that offer hope and probably more benefit to people with cancer than the standard conventional therapies, but that wouldn't be hard."
Chowka added that beyond demonstrating efficacy, the clinicians and clinics associated with alternative cancer therapies need to be effective at getting the news of their results to potential patients. "This is a sad commentary, but it takes not only clinical effectiveness, but a sophisticated effort to mobilize the information, make it public, and promote it. A place that has done that very well is American Biologics (AB), S.A. Michael Culbert of AB is an old friend of mine and has done exceptional work in this field. He's a great ‘minister of propaganda’ for American Biologics and an excellent spin doctor for what they do. I wish the other clinics could take the best of what he's learned about disseminating information and adapt it to their own purposes. The name of the game today is that you have to be highly visible and stand up and call attention to yourself." Chowka added that he is particularly impressed when he finds former patients who step forward to say that they have been helped by an alternative approach, as occurred during his radio call-in talk shows or in conversations with Burzynski's patients during the court trials in 1997. "In my experience that tends to be the most legitimate response, where people are doing it not because they're making a buck but because they've been helped by the approach, they want to share it with others in need, and they're disgusted with the restrictions placed on their ability to make decisions and choices for their own health. That was the inspiration of Robert DeBragga's efforts in founding Project Cure, Inc." Chowka ended with some comments on how the field has changed since his first involvement in the 1970s. Although he remains skeptical of the possibilities for fair evaluation by organizations such as the NCI and the major cancer research institutions, he is enocuraged by how public perception and media coverage of alternative and complementary therapies have evolved over the years. He noted that back in the 1970s most press coverage was uniformly negative, such as the many articles blasting laetrile, but even so the debunking mainly served to alert the public to the existence of alternative medicine. "Every time one of those articles appeared, the calls to the laetrile clinics increased. I think the cat’s really out of the bag now, and the Establishment is confused and running scared. The Establishment is all over the map on this issue. On the one hand, all the medical schools are getting involved in alternative medicine, and on the other hand, the powers-that-be can’t quite get down off their high horses to implement progressive changes or even to catch up to where the public is at. The public is using alternative medicine to an extent previously undreamed of, and where is the medical Establishment? They’re still putting the brakes on it: ‘Yes, here’s the latest positive study on nutrition and cancer, but we believe that you shouldn’t modify your diet because still more studies are needed.’" Chowka added that although the public’s acceptance of alternative medicine has grown since the 1970s, and media coverage has tended to become more balanced, the level of Congressional oversight of the NCI, paradoxically, has diminished. "There's no longer the degree of interest and awareness on Capitol Hill that could have made more of a difference. I would also fault the media and the journalistic community for dropping the ball. The high point for me was the late 1970s through the early 1980s, when the mainstream media covered the politics of cancer at the level of respected network magazine programs like 20/20 and 60 Minutes, in numerous feature articles, and on hundreds of talk shows. The coverage was not only about therapies--what are the latest 'cures' in cancer--but where are our tax dollars going--are they really going towards positive ends, or at we just pouring them down the same rat hole? It's a much harder sell now to get that story out into the media, which seems, whenever they do stories on alternative medicine, to be preoccupied instead with a softer approach (meditation, acupuncture, homeopathy) and alternative medicine’s non-controversial ‘integration’ into the mainstream. "We just had the twenty-fifth anniversary of the war on cancer, and the media love anniversaries. What did they do on this anniversary? Nothing. They should really have taken a hard look at what's going on. Two weeks ago John Bailar's latest salvo against the Cancer War appeared in the New England Journal of Medicine. According to him, we're still at ground zero. It was a blip in the media, but they don't follow it up." Chowka does not think there is a conspiracy to downplay coverage of cancer politics; rather, he attributed the change in part to the degradation of the media toward covering cheap, sensationalistic, celebrity-driven stories. In short, Chowka suggests that although the public is turning to alternative and complementary therapies in increasing numbers, the media and elected political officials have yet to translate the change into a critical reappraisal of conventional cancer research and therapeutics.
Finally, Chowka commented on how the growing acceptance of alternative and complementary therapies brings with it new and, in some ways, more complicated problems. When he first began to cover the field during the 1970s, "The pioneers were active: Linus Pauling, the laetrile freedom-of-choice people, the metabolic therapy pioneers, William Donald Kelley, and Dean Burk, Ph.D (a founder of the NCI and an alternative therapy proponent). These individuals had to be strong personalities who had something clinically viable to offer in order for them to challenge the Establishment and get their point of view across. In many ways alternative therapy has now become quasi-mainstream, more acceptable, and more economically entrenched. We could talk for hours about the concerns that arise when alternative medicine finally reaches a certain level. A whole new set of problems emerges in terms of exploitation and other pitfalls that didn't exist back in the 1970s. Another danger that is emerging with the mainstreaming of alternative medicine involves the ways in which the medical profession and cancer establishment may co-opt the public movement toward greater patient autonomy and medical freedom. "For example, I see naturopathic medicine as very promising as well as highly promotable and marketable. Not surprisingly, the Establishment is now increasingly interested in it and, from what I can see, in co-opting it. The whole thrust lately is towards integrated or complementary medicine, with a small 'i' and a small 'c.' But complementary medicine is considered to be viable by the mainstream only as long as conventional medicine retains its leadership role. A true partnership (between complementary/alternative and conventional) is one thing, but the people who are determining the future of medicine apparently do not view it that way. They are M.D.-centric and still see M.D.s and prospective, double-blind controlled clinical trials in the driver's seat. I think that's the past. It's not the future, and it's not really even the present. "The American public is clearly out in front. Across the board the major opinion polls, whenever the question is asked, consistently find that the American public supports freedom of choice and unfettered access to whatever therapy might help them. In other words: We're grown-up. We're responsible. We don't need big brother."
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