Thursday, June 10, 1999
2154 Rayburn House Office Building
Washington, DC

My personal odyssey with breast cancer led me to an intimate knowledge of both conventional and non-conventional approaches. Up front, I want to say two things. I do not think any one approach is right for everyone. And I have suffered no irreparable harm from any non-conventional approach despite having had extensive exposure to many!

There is a growing body of research studies documenting the effectiveness of both complementary and alternative approaches to cancer detection, treatment, and even prevention. But cancer research seems to be a highly political process often with formidable barriers to the conduct of true scientific inquiry.

There are numerous cases of unexplained "spontaneous remissions" reported in the medical journals. When will we begin to study these exemplary cases as a group and identify any commonalities which may exist for future study? Unless funds are earmarked specifically for these novel types of studies it seems unlikely that they will be conducted.

Unsophisticated design of research is another problem. A study can be very tightly controlled and rigorous, yet lack the sophisticated design to look for such thing as interactions between variables. This is especially true when we begin to talk about designing transdisciplinary studies which cross the imaginary line between mind and body.

Recently I read that Dr. Linus Pauling, the only person in history to have won two unshared Nobel prizes, tried to interest conventional cancer specialists in studying a non-conventional approach - namely, the use of Vitamin C as an adjunct to cancer treatment. Despite highly promising preliminary outcomes in actual usage with cancer patients, he found no interest or support from NCI. The two studies which were ultimately funded by NCI were both awarded to the Mayo Clinic which did not follow the protocol guidelines specified by Dr. Pauling. Yet NCI accepted Mayo's conclusions that vitamin C was ineffective in cancer treatment and stated that no further studies should be done to investigate it!

When I took courses on scientific research design, I was taught that science never closes the book of scientific inquiry. I was taught that science cannot prove anything, that it can only disprove hypotheses, and that the most well-established "facts" are merely hypotheses for which no one has yet found a competing, plausible explanation or a way to test it.

The Mayo Clinic researcher also refused to allow Dr. Pauling to examine the raw data. This brings up a critical point. If we are to have the best information available to us on issues as important as cancer, why is it that raw data is not shared once the original investigators have had a reasonable time to prepare a scientific report of their findings? Why is it that we fail to encourage or even allow the best minds to grapple with the data, analyze it from differing perspectives, and identify and defend alternate conclusions in the true spirit of scientific inquiry?

The problem of inaccessibility of data is a serious obstacle to the progress of true science. It also enables many abuses and the need for an Office of Scientific Integrity, and laws to protect people referred to as "whistle-blowers". Is it possible that researchers do not want true scientific inquiry to muddy their waters? Or perhaps they’re afraid the waters will be cleared up and everyone will be able to see what is at the bottom.

Precedents exist for placement of what are sometimes referred to as "public use data sets" on the World Wide Web. Raw data which has been appropriately coded to protect confidentiality could contribute substantially to scientific dialog and progress.

One of the issues the Committee on Government Reform is addressing today is early detection. But early detection is too late! We desperately need research to identify precursors of cancer which are potentially reversible before cancer can get a foothold. Given our current track record for curing cancer, waiting until cancer occurs and detecting it early cannot be acceptable. A high priority for cancer research must be the investigation of methods which provide clues to biomarkers and other measurable features associated with cancer.

 Another barrier to the use of complementary and alternative approaches appears to be a basic conceptual schism regarding whether the nature of cancer is essentially local or systemic. If one believes that cancer is localized than such things as mastectomy and prophylactic mastectomy are obviously treatment, and not barbaric anachronisms in our sophisticated, high tech age. (I know of at least one 19 year old who has had a double mastectomy.)

However, an increasing number of conventionally-trained cancer specialists now believe that cancer is systemic, not local, and that it is the biological terrain of an organism which must be addressed. Just as plants will flourish under certain environmental conditions and perish in others, the biological terrain is what provides an inhibiting environment or an enabling environment for the proliferation of cancer.

Is it possible that someday we might say that cancer is the presence of a certain chemistry of the blood? Or that the world is not flat, and is not the center of the universe as it so obviously seems to be? During chemotherapy my blood counts would hit rock bottom which meant the drugs were killing everything they touched. My oncologist was happy about this, and he was also happy about the fact that my counts would quickly come back up. But he could not explain it. Why did healing happen quickly for me but not for others?

Conventional cancer treatment has no way of knowing if a specific drug will work for a specific person. Every drug is essentially an experimental drug for any given individual. In fact, there are research facilities which can test a piece of a person's tumor, and determine which drugs will work best to kill that kind of cancer cell. Yet the actual survival rates are unchanged! In other words, if you take a drug that is tailored to killing the cells in your particular tumor, this does not impact your overall chances of survival! What is wrong with this picture? Could it be that killing cancer cells is not the way to cure cancer? The conventional approach to cancer treatment is apparently straightforward, and seems to make common sense - detect cancer cells and kill them. And even when this approach is successful in killing tumor cells, the cancer too often "comes back with a vengeance". As one pathologist said to me recently, "You just don't know how breast cancer is going to behave."

The bottom line is that there are no guarantees that simply killing cancer cells will keep you alive - even if you survive the treatment. You have to find ways to keep yourself alive. If the role of conventional approach is to detect and kill cancer cells, what might be the role of complementary and alternative approaches? Over 50% of cancer patients include the use of complementary and alternative approaches in their treatment regime. I believe they have discovered that these are the approaches that will keep them alive.

Does complementary and alternative medicine offer false hope? Dr. David Bressler and Dr. Marty Rossman, founders of the International Academy for Guided Imagery, talk about the importance of giving patients neither false hope or false despair. They ask patients to consider what outcome they would like to have if they were in charge. They emphasize that although we do not know what the outcome will be, we can still cast our vote. And with imagery we can vote frequently by putting our attention on the desired outcome, instead of on potential undesired outcomes in the form of worry. There is increasing scientific support for the power of the mind-body connection.

In conclusion, the following brief quote gives us cause for optimism as well as guidance for future research directions. "I think it likely that many of our diseases work in (the following) way...We tear ourselves to pieces because of symbols and we are more vulnerable to this than to any host of predators. We are, in effect, at the mercy of our own Pentagons, most of the time." This was written not by a psychologist, but by an eminent biological scientist, Dr. Lewis Thomas, past-president of Sloan-Kettering Cancer Center.

N. Lee Gardener