Focus on Alternative and Complementary Therapies
www.pharmpress.com/fact
Focus Alternat Complement Ther©2005 Pharmaceutical Press
Focus Altern Complement Ther 2007; 12: 167–9
Faced with a diagnosis of cancer, many patients are tempted to try ‘alternative’ treatment options.1 This temptation is increased by the mass media’s current obsession with the subject. Each month, UK national newspapers publish around 400 articles on ‘alternative medicine’, and there are now about 40 million websites promoting such treatments.
The aim of this piece of investigative journalism was to find out what actually happens when a patient decides to consult providers of alternative medicine (POAM).
In January 2005, one of us (BC, a journalist by profession) resolved to investigate ‘alternative’ medicine for cancer as it is currently practised in the UK. With the help of the oncology team at Guy’s and St Thomas’ Hospitals, London, a plausible story was devised about a ‘patient’ to be presented to six POAMs.2 The ‘patient’, a young, previously healthy man, had been diagnosed with Hodgkin’s disease. After 6 months of chemotherapy, he had gone into remission, but now the disease had recurred and there were liver metastases. The details of this story were deliberately designed such that the prognosis of the ‘patient’ would be good.3 The six POAMs were selected by BC at random, after typing the terms ‘alternative medicine’ and ‘cancer’ into a search engine, but no formal procedures were followed. None of the practitioners was previously known to BC. Six practitioners were chosen because this seemed a feasible task, and a sufficiently large number to draw conclusions from the experiment. No ethics approval was sought. The key question the ‘patient’ posed to all the POAMs was: ‘Are there any alternatives to chemotherapy, the treatment advised by my oncology team, that you deem to be effective?’ All consultations were taped and the practitioners were later informed that this was for publication; none objected. The following is a brief narrative account of the six consultations.
The first POAM did not examine the ‘patient’ nor did he take a medical history, stating that this was unnecessary because his advice to cancer patients was always the same. He recommended using a ‘Rife machine’ and ozone therapy, explaining that these treatments were expensive but could save the patient’s life. In addition, he advised regular ‘liver flushes’ (fasting, detoxifying supplements and colonic irrigation) and radionics. These treatments came to a total cost of £9844.82.
The second POAM used the title ‘doctor’ but was not GMC-registered. She took a detailed history and examined the ‘patient’s’ abdomen. She then recommended a treatment package using electromagnetic energy, ozone autohaemotherapy (reinjecting the patient’s own blood after ex vivo exposure to ozone), inhalation of ‘active oxygen’ and soft laser. She explained that these treatments would need to be applied for at least 3 months on an inpatient basis; she went on to say that although this would be very expensive, it cures people, and that some therapies could be omitted to save money. Chemotherapy was said to be contraindicated in conjunction with this approach. Total cost: £11 830.
The third POAM, also a ‘doctor’ but not GMC-registered, asked the ‘patient’ to complete a questionnaire but did not examine him. He explained that conventional treatments are effective for a relapse of Hodgkin’s disease and recommended adhering to his oncologist’s advice. To assist recovery he recommended kinesiology. There were no charges for this consultation.
The fourth POAM, a non-doctor, consulted via telephone from his home. He took a medical history and subsequently claimed that chemotherapy would be ineffective. He explained that cancer was caused by parasites that can be killed with herbal and other natural supplements in combination with a ‘zapper’ (an electrical device to eliminate parasites). This is known as ‘the Dr Hulda Clark protocol’, and he pointed out that he was only educating people in this approach. He also recommended several unconventional diagnostic tests. Total cost: £1137.25.
The fifth POAM, a medical doctor, took a medical history but did not examine the ‘patient’. He claimed that chemotherapy would be of little use. Instead he recommended ‘Aqua Tilis’ (a sauna filled with antioxidant steam and magnetic fields) as well as vitamin C, and Laetrile infusions followed by oral maintenance therapy, a treatment he called ‘non-toxic chemotherapy’. He claimed this regimen would destroy the cancerous cells, and that people with this type of cancer had been cured by Aqua Tilis. Total cost: £3712.
The sixth POAM was also a medical, GMC-registered practitioner. His nurse took a history and performed a ‘live blood analysis’ to look for pathogens and see whether the ‘patient’s’ immune system was working adequately. This was followed by an examination of the abdomen by the doctor himself and a scan in an ‘Oberon machine’, which appeared to be an attachment to the doctor’s computer. The ‘patient’ did not need to do anything. The doctor said that a small microphone-like device beside the computer monitor was sending out electromagnetic waves that resonated with the ‘patient’s’ internal organs. He told the ‘patient’ that he could ‘see’ that there were ‘problems’ in the liver, even though the machine was not 100% accurate. He claimed that chemotherapy was unlikely to work in this case and recommended photodynamic light therapy for tumour destruction instead. He also suggested seeing a nutritionist who could recommend dietary changes and supplements for detoxification and stimulation of the immune system. He regretted that all this would be expensive but that it could save the ‘patient’s’ life. Total cost: £8894.48 plus £245 for the consultation.
Several POAMs commented – after having been debriefed that their ‘patient’ was, in fact, a journalist –that there was no point in publishing this experience: the medical community would not believe it anyway! The ‘patient’ noted that, on the surface, many of the consultations seemed ‘business-like’ and empathic. The clinics were professionally run, and some of the offices were in prestigious locations (e.g. Harley Street). The consultations offered apparently plausible explanations, treatments and advice.
It is clear that this ‘experiment’ is not a scientific investigation but a piece of investigative journalism. Some might therefore question its ethics. It has been pointed out, however, that in order to disclose unethical behaviour in medicine, undercover investigations may be the only feasible approach.4 The methods used are those of a journalist and not of a scientist.
Several common themes seem to emerge from these six consultations:
There is little question that the behaviour of several of the six POAMs was irresponsible. Leibovici eloquently argued that we are ‘ill-equipped to deal with the clamour of alternative medicine’.5 Patients are exposed to an incessant flow of mostly misleading information on this subject.6,7 The late John Diamond left us a moving account of the turmoil cancer patients may experience as a consequence.8 We would argue that behaviour such as that described above is unethical. One of the POAMs, a GMC-registered practitioner, is currently being considered for investigation by the GMC. Non-medically qualified POAMs are usually unregulated and therefore seem to operate in a legal vacuum. The high cost of the treatments could signal to desperate patients the ‘cutting edge’ nature of the therapies. Patients are often incapable of ‘recognis[ing] the loud signals of alternative medicine as false’.5 The risk thus increases. US authors recently demonstrated that using ‘alternative’ treatments instead of conventional therapies for breast cancer increases recurrence and reduces life expectancy.9 It should be noted, however, that not all use of unconventional treatments is to the detriment of cancer patients. Some treatments used in palliative and supportive care are likely to be of benefit, for example acupuncture for control of nausea and aromatherapy or relaxation for stress reduction.10 They have the potential to enhance quality of life, e.g. by reducing symptoms or improving general well-being. None of these approaches, however, claims to cure cancer. Whenever alternative treatments are promoted as a substitute for conventional therapies, the risk can be considerable.
This study has several rather obvious limitations. It was not designed as a scientific test but as a journalistic investigation. The sample size is minute and many of the results are subjective; we cannot therefore draw generalisable, definite conclusions. We can, however, alert readers to a potential problem and stimulate others to consider solutions. At the very least, clinicians should discuss the subject of ‘alternative’ medicine openly with their patients.11
In conclusion, POAMs are keen to advise cancer patients on ‘alternative’ cancer cures. In the majority of cases, their advice seems to be irresponsible, unethical and dangerous. We should consider means of preventing harm to and exploitation of cancer patients.
