Comments on Dr Ralph Moss’ critique of German New Medicine

By Don Benjamin

Oct 2009

Ralph Moss has written a scathing critique of Dr Ryke Geerd Hamer’s German New Medicine (GNM)¹.  It is a very useful report because it contains many facts that are hard to track down and provides useful information about other groups that have carried out assessments of German New Medicine.

 However it contains several examples of inherent bias that one would expect in any assessment by medical orthodoxy of a new alternative therapy that questions the current orthodox paradigm, but would not expect to find in a critique by someone of Ralph Moss’ calibre and expertise in complementary and alternative therapies. For example,

·   Moss refers to but has clearly not read the details of the Five Biological Laws of GNM.  He then tries to assess the GNM based on claims that GNM does not make.

·   He quotes examples of testimonials from a website and then claims that they do not include adequate information or documentation for an outsider to use them for assessing the benefits of the therapy

·   He claims benefits for orthodox medicine that remain unproven and ridicules those who question such claims

·   He accepts the claims of orthodox practitioners that the metastasis process involves circulating cancer cells despite there being very little evidence for the claimed mechanism; and criticises those who question such an unproven claim.

·    He claims that ring structures in brain CTs must be artifacts, not biological phenomena, trusting the opinions of medical specialists and ridiculing evidence from researchers (such as Bjőrn Nordenstrőm from Karolinska Hospital in Stockholm) who, like Hamer suggested an alternative explanation for some of them.

Moss also assessed the statistics for success claimed for GNM treatment and came to the reasonable conclusion that the claim of 92% 5-year survival for 6,500 of Hamer’s cancer patients treated from 1990-1995 was invalid.  However there are some faults in his assessment.

Finally he devoted over 10% of the report to showing that Hamer was anti-Semitic, and providing evidence that he was ‘delusional’.  The implication from this was that his ‘unreason’ can therefore be extended to his medical thinking.  This again displays a lack of logic.

 The following is an assessment of these five areas where Moss has shown bias and some comments on Hamer’s success statistics and the relevance of Hamer’s ‘delusional’ thinking to his medical thinking.

The Five Principles

Moss paraphrases Hamer’s five biological laws or rules, then completely misrepresents their implications for the therapy.  For example, GNM states that the reaction of an individual to an unanticipated event depends on the part of the brain affected by the event:

·  the old, primitive, reptilian brain (brainstem), the part affected in animals;

·  the middle brain (cerebellum and cerebral medulla); or

· the new brain (cerebral cortex), present only in higher animals and humans².   

Hamer states that reactions in animals and birds can only occur in the old brain and are instinctive reactions to unanticipated events (such as a deer observing her fawn being killed) that threaten the integrity of the herd or nest. He does not use the word ‘emotions’ but describes the conflicts in humans and higher mammals, such as anger, as “inter-animal, at least for us mammals…man [suffers these conflicts] mostly in a transposed sense (for example, verbal mediation)” and these, when part of interpersonal relationships, are experienced in the cerebral cortex³.

 Yet Moss mentions this principle simply as “The science of embryology and knowledge of human evolution is the foundation of medicine” without any reference to the different parts of the brain which are an essential element in understanding GNM.  In Chapter V. Ten Objections to Hamer’s Theory, after stating that birds and animals also get tumours, including metastases, he states in relation to Cancer in Animals (page 60): “Whatever the emotional life of a parakeet or a gerbil may be, few would argue that it includes the complicated, quintessential human feelings of the sort that Hamer ascribes to the DHS” (the Dirk Hamer Syndrome, whereby the unanticipated event causes a tumour).  Hamer does not ascribe emotions of any sort to animals or birds. Moss therefore misrepresents one of the basic principles of GNM.

In the section Latency Period (Lag Time) (Page 61) Moss states that “In medical science the latency period is generally measured in years, sometimes even in decades, and not in days, weeks or months.  This is one of the sharpest points of disagreement between GNM and modern oncology”.  He argues that “Hamer’s own testicular tumour diagnosed about two months after his son’s demise” therefore could not have been caused by his son’s death.

Yet on the previous page in Cancer in Children (page 60) he also argues that tumours cannot be caused by emotional shock because neuroblastomas are observed in 1-year old children and “sometimes even present at birth.  In fact, neuroblastoma is sometimes detected in utero, before the birth of the child! ….Babies, much less foetuses, are insufficiently aware of their surroundings to suffer from mature emotional conflicts…”  By using this example, Moss not only undermines his argument on the Latency Period of tumours, but also reveals a lack of knowledge or awareness of modern holistic principles, such as those described by Bruce Lipton⁴.   These suggest that the cell’s environment picks up external stresses even before birth.  To suggest that a foetus is unaffected by the mother’s emotional reaction to an unanticipated event shows a serious ignorance of the proven link between emotions and the chemicals they produce⁵ and which can travel via the placenta to the foetus. There is also the holistic principle that emotions and chemicals are just different forms of energy and cells respond to energy in all its forms, not depending only on the receptors on the cell’s membrane.

In the Section on Asbestos and Mesothelioma (page 61) Moss argues that as this tumour has a latency period of between 15 and 50 years it could not possibly be caused by an unanticipated event.

There is general agreement among orthodox practitioners that some benign tumours can become malignant in a relative short space of time.  In fact it is known that relatively easily observed cervical tumours fluctuate backwards and forwards between the benign and malignant states during a matter of months⁶.  It is therefore possible for there to be a non-malignant tumour developing over a 40 year period after exposure to asbestos that could rapidly become malignant after an unanticipated event and produce symptoms within a year.  Moss is surely aware of this phenomenon.  He makes the same argument in relation to the latency period in the case of radiation and thyroid cancer (28-36 years), xenoestrogens and testicular cancer (median period 20 years) and tobacco and lung cancer (usually decades).

 Testimonials

 In Section IV Putting Hamer to the Test (page 42) he lists four rules laid down by the NCI’s Office of Complementary and Alternative Medicine for assessing the efficacy of a therapy:

·  there must be a definitive diagnosis of cancer

·  there must be documentation recording the tumour’s response to the treatment (tumour size)

·  there must be no other therapies that might have produced the response (confounders); and

·  there must be a documented history including dates and types of interventions and responses during the period in question.

 These are all fairly reasonable requirements.  Moss states that there are several dozen anecdotal testimonials of Hamer’s success with GNM on the website of Caroline Markolin, one of Hamer’s supporters in Canada.  He then selects ten of them and says that “he has not been able to identify a single documented case of cancer that was definitively proven to be caused by a DHS or healed through Hamer’s methods”. This is not surprising since websites rarely put all the available detail about a cancer patient, such as X-rays etc, on public view.  However Moss assumes that the information on the website is all there is that is available for these anecdotes.

 Moss submitted a list of 15 questions to Caroline Markolin hoping that she would get Hamer to answer them.  These included six in relation to the claimed statistics of 92 percent 5-year survivals; two on the ring structures observed on X-rays; two on tumours observed in one-year olds (neuroblastomas) and tumours in cats, dogs and birds; one on mesothelioma and testicular cancer (latency period); and three related to statements from Hamer that would appear to be anti-Semitic. Unfortunately she was not prepared to answer his 15 questions.  He quotes her as stating that “while she usually welcomed scientific discussions, she found the ‘provocative’ and ‘confrontational’ nature and tone of my questions not conducive to a constructive dialogue”.  She therefore found herself in a position, she said, where she had to “decline my offer of an interview”.

 He emailed her his list on 23 June 2009 and had not received a reply by the end of July 2009 when he issued his report.  I would have thought that five weeks would hardly be sufficient time for anyone to give a satisfactory response to this wide range of questions involving communicating them to Hamer and translating his responses back into English (had she chosen to respond).  He does not say why he did not address similar questions to Ilsedora Laker, Hamer’s other main supporter in Canada.

Benefits for orthodox therapies

One of Moss’ main criticisms of GNM is based on the fact that Hamer was opposed to all orthodox therapies on the grounds that they were not only ineffective but also harmful and antagonistic to the healing process.  Therefore Hamer and his supporters cause many deaths because “it will alarm many scientifically unsophisticated patients and might induce them to abandon potentially curative treatments (such as surgery for early-stage cancer)”.  Moss makes this statement in the context of chemotherapy where he cites Hamer as stating in December 2004 that “the usual survival rate of patients treated traditionally is only 2 to 3 percent, according to the German Cancer Research Centre in Heidelberg”.  Moss attributes this to the findings of Ulrich Abel whose statistics referred to advanced epithelial cancer (ie late stage solid tumours).  He says “Hamer misuses Abel’s findings, by extending them to cancer treatment as a whole, and ignoring developments over the past 20 years.  It is an absurd caricature of the state of cancer therapy”.

This reveals an inconsistency in Moss’ thinking.  Firstly, in relation to surgery for early stage cancer,

·  there has never been a single randomised controlled clinical trial that shows any survival benefit from surgery for any type of cancer compared to no surgery⁷

·  all the randomised controlled trials comparing different degrees of surgical intervention for breast cancer show no difference in survival⁸

·  all the randomised controlled trials evaluating the benefits of screening show no overall survival benefits from early detection and treatment of cancer⁹.

So Moss’ own claim that surgery for early-stage cancer is potentially curative is unproven.

As far as chemotherapy is concerned, a recent study by Australian medical scientists has confirmed that chemotherapy for solid tumours adds only 2.3 percent to five-year survival¹⁰.  Adding non-epithelial cancers, such as leukaemia, increases this figure to around 3 percent. Adding surgery (for tumours threatening vital organs, such as obstructing the bowel) and radiotherapy for similar situations and some other rare cancers takes the figure to about 7 percent.

So Moss’ claim that survival benefits of 2 to 3 percent “is an absurd caricature of the state of cancer therapy” is not borne out by the latest statistics.

 In reference to one testimonial, Moss also refers to certain other “treatments with known therapeutic potential (such as high-dose radiation therapy) [for Stage IV breast cancer] that could explain observed survival benefits in people treated by Dr Hamer.  On the contrary the latest evidence from a review of randomised controlled trials suggests that such therapy involving radiation above a particular dose does more harm than good¹¹.

 The meaning of metastases

 Dr Hamer states that metastases are simply new tumour occurrences caused by new unanticipated emotional conflict-shock events.  Moss admits that “the debate about exactly how metastatic cells spread remained lively into the 20^th and even the 21^st century” yet dismisses Dr Hamer’s quite valid claim that there is in fact no proven mechanism for cancer cells to travel from one part of the body to another and produce metastatic growth.  Moss misrepresents this as a claim that cancer cells do not circulate in the blood.  It is the mechanism and rationale for seeding of a new tumour growth by circulating cancer cells in another site that is not proven; nor is why this new tumour growth is invariably fatal whereas primary tumours are not.

 Hamer’s claim that cancer cells cannot spread / metastasize are based in his claim (again misunderstood by Moss) that cells from one embryonic layer (say, the endoderm) cannot become part of either of the other two germ cell layers (the mesoderm or the ectoderm) which would be required in metastases². For example Hamer claims that the endodermal layer in the embryo develops into the organs related to the tube known as the alimentary canal, from the mouth to the rectum, as well as the prostate, uterus, lungs, liver parenchyma, pancreas, the bladder trigonum and all endocrine glands. However this does not include the epithelium of the pharynx, epithelium of the digestive glands and their ducts (liver, pancreatic ducts), respiratory organs (larynx, bronchi) and the interstitial part of the bladder which are ectodermal in origin. The mesoderm develops into the skeleton, muscle, connective tissue, circulatory organs (heart muscle, blood and lymph vessels and blood-forming organs), excretory organs (kidney parenchyma), reproductive organs (testes, ovaries) and adrenal cortex.  The ectoderm also develops into the nervous system, parts of our sensory organs, epithelium of the mouth invaginating down into the first 2/3rds of the esophagus, the entire outer skin, the milk ducts, the brain, spinal cord, tooth enamel, as well as the first 12 centimeters up into the rectum.

 However whether or not Hamer’s alternative interpretation of metastases is valid or not, Moss is not justified in claiming that the mechanism is proven and understood.   In fact there are much more likely explanations for secondary tumour growths than the concept of spreading tumour cells that seed at remote sites.

For example, James Devitt (the eminent Canadian breast cancer surgeon who was the keynote speaker at the Lancer Breast Cancer Conference in Belgium in 1994) questioned the role of circulating cancer cells in metastases because, for breast cancer cells to spread to the usual metastatic sites would require them to travel through or past many other organs where metastases also occur, yet do not in many cases¹². For example a cell spreading from an invasive intraductal breast carcinoma would have to travel through the pulmonary capillaries, the intestinal capillary bed and renal capillary beds.  Yet only some of these patients exhibit “metastases” in the liver, lungs, intestine, kidney, abdominal lymph nodes or adrenals.  He asks why some women get metastases in one or more of these sites but not others.  He concludes:

 ….If the breast lesion is not the cause of the disease but merely the local expression of a combination of changes in both local and systemic growth-restraining factors, and if such a combination was more or less specific for producing breast-tissue-like growths, they would be more easily induced and occur earlier in breast tissue. Occurrence in other tissues or sites would be later for this reason rather than because mechanical spread had taken place. This might explain the entirely different "metastatic" pattern and courses [in different] patients.

Similarly, lesions might appear in the regional lymph nodes because of a greater concentration of abnormal growth controlling humours in the lymph draining there; the tumour might even produce such humours. Perhaps lesions manifest in other organs and tissues because the release from growth restraint allows the greater growth potential of embryonic cell ancestors to reappear¹².

 These questions have not been answered in the intervening 15 years. Josef Issels suggested that tumour growth requires the internal milieu, involving the immune and other system, to become sufficiently weakened by several factors¹³.

 Therefore a much simpler explanation of the metastasis process that does not involve the spreading of tumour cells is that

·  the body’s internal milieu, including the strength of the immune system, determines if cancer can grow anywhere in the body

·  by the time any tumour has started to grow, and before it is detected, cancer is already a systemic disease (Devitt¹², Issels¹³)

·  the cancer process can reverse itself if the internal milieu reverts to normal, eg by a weakened immune system returning to normal

·  if the cancer process continues, the first tumour is detected in the most susceptible site, for example one where there is the most tissue damage or repair taking place, or because the release from growth restraint allows the greater growth potential of embryonic cell ancestors to reappear¹², or where (in Dr Hamer’s terminology) an emotional trauma might produce a conflict- mechanism determined by the person’s reaction to the unanticipated event.

·  the appearance of a particular tumour is characteristic of the tissue where it first arises, so all breast tumours that arise in breast gland tissue look similar and different from tumours in different organs.  (Devitt suggests that breast tumours are so-called only because they are usually first seen in breast tissue, this being the most susceptible tissue for that type of cancer¹².)

·   if the cancer process continues, second tumours arise in the next most susceptible tissue, which might be nearby lymph nodes.

·  if the cancer process still continues unchecked, tumours are detected in tissues of more remote organs as their tissue becomes the next most susceptible to tumour growth.  The cells of the tumour would resemble those of the primary tumour because it was caused by the same emotional trauma, not necessarily because it had spread from the primary site.

·    “Metastases” always occur after “primary” tumours, often after a lengthy time delay. Issels describes how, as tumours grow, they gradually undermine the body’s digestive, endocrine, metabolic and immune systems¹³. So it should not be surprising that such later stage cancers would be invariably fatal.  Slow growing tumours are characterised by lengthy survival (such as with most prostate cancers) with little opportunity for metastases to develop before the person dies from other causes; with fast-growing tumours the growth restraining factors are much weaker so shorter survival would be expected, with time for “metastases” to develop.

If it is claimed by cancer specialists that metastasised cancer cells are linked to primary tumours by their appearance, then, according to Hamer’s hypothesis, the cancer cells of a metastatic tumour would only resemble those of the primary tumour if there were a second emotional trauma similar to the original one that caused the primary tumour.  If a poor prognosis further undermined the immune system and accelerated the existing cancer process, it would accelerate tumour growth of the same type.  If the poor prognosis were a new unanticipated event different from the first one and caused another tumour, as Hamer suggests, its appearance would be completely different and unrelated to the primary tumour. In this sense Dr Hamer’s explanation of metastases resulting from the unanticipated doctor’s diagnosis, particularly a poor prognosis, would often be invalid.

The metastasis theory also does not explain those cancers where no primary tumour was discovered.

So Moss is not justified in claiming metastases via spreading are a proven phenomenon just because most cancer experts claim it is so.  However he has identified an inconsistency in Hamer’s claims.

Ring Structures in X-rays

The appearance of concentric rings on earlier X-rays and more modern CT scans has been known for a long time.  For example Dr Björn Nordernström, Professor of Diagnostic Radiology at the Karolinska Institut and Hospital in Stockholm observed them in lung X-rays in the 1950s.  He asked his colleagues what they were.  They suggested he ignore them as they were unexplained artefacts.  Instead he chose to ignore his colleagues and explaining the mysterious ‘corona structures’ prompted him to carry out further research.  He discovered they were caused by an uneven distribution of water due to altered extracellular fluid dynamics, caused in turn by fluctuating electrical potentials. 

After several more years of research he had developed a completely new paradigm of what cancer is and how it could be treated.  In the process he confirmed the existence of chakras and their importance in health.  Because of opposition to his approach, which questioned the current cancer paradigm he was, like Hamer, forced to publish his findings himself in 1983¹⁴.  He continued his research in China, where the orthodox and alternative paradigms often co-exist in the same hospitals and research centres.

The claimed success statistics

The one area where Moss is on more solid ground is in his questioning of Hamer’s claim that 92 percent of 6,500 cancer patients treated by him had survived 5 years.  Moss tried without success to establish documentation for these statistics, which had allegedly been arrived at by the public prosecutor in Hamer’s trial. Moss was not able to identify the prosecutor in question who was alleged to have provided such statistics.

According to Moss, Austrian health authorities closed down Hamer’s Cancer Clinic in Burgau, Austria in late 1995 (or early 1996).  Moss states that “during this 5-year period (1990-1995), by Hamer’s account, he saw a total of about 6,500 patients” (page 35).  Moss argues that only those patients treated during 1990 would have had reached a 5-year anniversary of their treatment by the end of 1995. (In fact the period from 1990 to the end of 1995 (or early 1996) is longer than 5 years.) 

Moss argues that it would not have been possible to track down 6,500 patients in the time available to the prosecutor.  He overlooks an alternative possibility: With such large numbers involved it would have been more practicable to follow up a few hundred of those treated in 1990 to gain a representative sample.  However the prosecutor would have no interest in finding recovered cancer patients.  He would only require documentation on a small number to show Hamer had treated them illegally (as happened in Josef Issels’ trial).

A more realistic estimate came from an investigation by the German magazine Der Spiegel through the German authorities.  They identified 50 patients with metastatic cancer who had been in the care of Hamer and only 7 had survived.  An appraisal by Ventegodt et al of Hamer’s five “medical laws” included the statement that, in reference to the Der Spiegel finding, “we find that when treated only with psychosocial intervention, a success rate of 15% with this group of mortally ill metastatic cancer patients is remarkable and encouraging for further research”¹⁵. (See below)

The Ventegodt Appraisal

On page 71 of his report Moss refers to an academic assessment of Hamer’s work by researchers in the field of holistic medicine led by Søren Ventegodt, MD.  Unlike Moss they concluded that

“Altogether, it seems that Hamer is in accordance with contemporary holistic medical theory, as the most fundamental principles of his work are built on an understanding very similar to holistic medical thinkers of today and of the past; regarding the most fundamental postulate that cancer patients can be healed by his system of holistic medicine could actually be the case for some of the motivated patients. This must be tested scientifically, however, before being accepted. If proven, we must recommend a rehabilitation of the name and work of Ryke Geerd Hamer. Clinical testing of a cure for cancer based on Hamer's system must be considered worth the effort; it must be done with physicians trained by Hamer if at all possible.”¹⁵ 

They in fact found that the first two of Hamer’s laws were “in agreement with the theories acknowledged by modern holistic medicine such as the theory of coherence by Aaron Antonovsky (1923-1994) that explains that health comes from re-establishing “coherence”. This is related to the work and ideas of Abraham Harold Maslow (1908-1970) and Viktor Emil Frankl (1905-1997) and the most progressive “resilience” literature, as well as our own work: the theory of the purpose of life and the life mission theory that explain that the cause of much suffering and disease results from resignation of the purpose of life”.

(These two laws state that all cancer forms arise from an emotional and biological shock; and that every disease has a pathogenic and a healing phase).

They were however unable to substantiate the remaining three rules (the symbolic linkage between psyche to the brain and the organs of the body; the claim that bacteria and viruses are controlled by the body and help the body in the healing process; and the claim that all diseases are rational and natural processes for the benefit of the patient).  They came to this conclusion by comparing Hamer’s claims with those of accepted orthodox biological processes, which they had no reason to question, in contrast with the first two laws, where there was much evidence, based on an alternative paradigm, on which to make an assessment.

Effect of delusional thinking on medical thinking

Moss uses 11 of the 86 pages of analysis (~12%) to show that Dr Hamer is anti-Semitic and delusional and concludes from this that “his unsupportable fantasies are more properly classified as signs of profound mental derangement” (page 84).  Moss then states that Hamer’s “ranting about an imaginary worldwide  Jewish conspiracy is more than just prejudiced; it is delusional… and speaks volumes about his state of mind …  One can detect much of the same paranoia, sloppiness and unreason in his medical thinking as in his social views” (page 85).

The evidence Moss presents for Hamer’s anti-Semitism is very strong, as is his evidence for Hamer’s paranoia.  However, it is understandable how a person who believes strongly in having discovered a way of saving thousands of lives only to be prosecuted and imprisoned for refusing to recant his beliefs, might feel.  In fact on page 88 Moss recounts the story of Ignaz Semmelweis, the 19^th century Hungarian physician who was scorned by his contemporaries because he urged them to scrub their hands to prevent the transmission of childbed fever.  He died in a mental hospital. One can understand how Semmelweis felt after he had successfully almost eliminated childbirth deaths from infection after implementing this simple precaution in his hospital, only to be ridiculed by the rest of his profession and his career destroyed.

The question Moss does not explore is, was Hamer “anti-Semitic”, “paranoid” and “mentally deranged” at the time he developed his German New Medicine” or did he only display these tendencies after his medical colleagues set out to destroy him for his heresies?  This is critical to the validity of Moss’ conclusions, as he states that a person in this state would be incapable of logical thinking.

Moss’ report is also useful in revealing the philosophy behind the Complementary and Alternative Medicine (CAM) movement in the United States, in particular the NCI’s Office of Cancer Complementary and Alternative Medicine (OCCAM) set up in October 1998.  (It now operates in competition to the National Institute of Health’s National Centre for Complementary and Alternative Medicine (NCCAM) that he helped set up (as the Office of Alternative Medicine) in 1992.  Both organisations receive ~$125 million in annual funding.) Moss states (page 74) that “To make conventional medicine more humanistic is CAM’s raison d’être”.  It is therefore not surprising that anyone such as Hamer, who rejects most conventional cancer intervention, would be considered to have nothing beneficial among his theories and principles.

Another factor is that German New Medicine is clearly part of psychotherapy. This area of therapy has received almost no recognition by supporters of conventional medicine despite having at least six randomized controlled clinical trials that show dramatic effects on survival with cancer patients ^16-20. Opposition to the idea that cancer might be caused by psychological or emotional trauma therefore appears to be based more on ideological grounds than any lack of scientific evidence.  The implications of this evidence ever becoming accepted are world shattering, if only because the cancer industry worldwide is worth in excess of $500 billion a year, and this industry is based entirely on a particular paradigm about what cancer is. Therapies based on this paradigm appear to provide benefits to barely 7% of those treated. Psychotherapies such as those developed by Ronald Grossarth-Maticek¹⁷ and Hamer, if found to be effective, would ultimately sound the death knell of orthodox cancer therapies. 

References

1.  CancerDecisions.com, Newsletter #402, 08/02/09 Introducing 'German New Medicine®'-Hope Or Hoax?

2.  Dr. med. Mag. Theol. Ryke Geerd Hamer. Scientific Chart of Germanic New Medicine. Amici di Dirk 2007.

3.  Dr. med. Mag. Theol. Ryke Geerd Hamer.  Summary of the new medicine, 3^rd edition, Amici di Dirk 2000, (p49).

4.  Lipton, BH.  The Biology of Belief: Unleashing the Power of Consciousness, Matter & Miracles. Hay House, 2008.

5.  Pert, C.  Molecules of Emotion. Simon & Schuster, New York, 1997, and as a Touchstone Book  in 1999.

6.  Green GH. Duration of Symptoms and Survival Rates for Invasive Cervical Cancer. Aust & NZ Journal of Obstet and Gynec 1970; 10: 238.

7.  Benjamin, DJ. The efficacy of surgical treatment of cancer. Medical Hypotheses 1993; 40 (2): 129-138.

8.  Benjamin, DJ. The efficacy of surgical treatment of breast cancer. Medical Hypotheses 1996; 47 (5): 389-97.

9.  Black W, Haggerstrom D and Welch HG. All-cause Mortality in Randomized Trials of Cancer Screening. J Natl Cancer Inst, 6 Feb 2002; 94(3):167-73.

10.  Morgan G et al. The contribution of cytotoxic chemotherapy to 5-year survival in adult malignancies. Clin Oncol (R Coll Radiol). (Dec) 2004; 16(8): 549-60.

11. Gebski, V et al. Survival effects of Postmastectomy Adjuvant Radiation Therapy using Biologically Equivalent Doses: A Clinical Perspective. JNCI 2006; 98 (1): 26-38.

12. Devitt JE.  Breast cancer: have we missed the forest because of the tree? Lancet 1994; 344: 734-35.

13. Issels, Josef. Cancer: A Second Opinion.  Hodder and Stoughton, London, 1975.

14. Nordenström. B. Biologically Closed Electric Circuits: Clinical, Experimental and Theoretical Evidence for an Additional Circulatory System. Nordic Medical Publications, Sweden, 1983.

15. Ventegodt, S et al. Rationality and Irrationality in Ryke Geerd Hamer’s System for Holistic Treatment of Metastatic Cancer. The Scientific World Journal 2005; 5: 93-102.

16. Fawzy FI et al. Malignant melanoma Effects of a brief, structured psychiatric intervention on survival and recurrence at 10-year follow-up. Arch Gen Psychiatry 2003; 60: 100-3.

17. Eysenck, HJ & Grossarth-Maticek, R.  Creative Novation Behaviour Therapy as a Prophylactic Treatment for Cancer and Coronary Heart Disease: Part II - Effects of Treatment. Behav Research and Therapy 1991; 29 (1): 17-31. (includes results from three randomised trials).

18.  McCorkle et al. A specialized home care intervention improves survival among older post-surgical cancer patients. J Am Geriatr Soc. 2000; 48:1707-13.

19.  Kuchler T et al. Impact of psychotherapeutic support on gastro-intestinal cancer patients undergoing surgery; survival results of a trial. Hepato-Gasteroenterol 1999; 46: 322-35.

20.  Cunningham A et al.  A randomised controlled trial of the effects of group psychological therapy on survival in women with metastatic breast cancer.  Psycho-oncology 1998; 7: 508-17.