The Other Medicine: Programme Four

FORD
One of the illnesses that causes the greatest anxiety and fear today, is cancer. And here CAM has much to offer, but here also is where it runs up against vehement opposition from the orthodoxy. So what are the issues over harm and advice when people, confronted by that dreaded diagnosis, attempt to find help and support?

In Bristol, I met Michelle who was diagnosed with breast cancer nearly four years ago.

MICHELLE
I first discovered I had a lump in my armpit and eventually went to the doctor to have this investigated. And it was discovered some weeks later that it was actually breast cancer that had spread to lymph nodes underneath my arm, so the decision then was taken to go very quickly to chemotherapy - the danger being that the cancer had spread to other parts of my body.

ACTUALITY - BRISTOL CANCER HELP CENTRE
Hello there.

Hi, hi Carol, hi Anna.

This is Anna Ford.

Hello.

FORD
As well as using conventional treatments such as chemotherapy and surgery, Michelle, feels very fortunate to have come here - to the Bristol Cancer Help Centre. It offers a range of supportive therapies through various residential courses, designed to give what its late co-founder Penny Brohn called "care for the mind, the spirit, the emotions, the heart and the soul". The sort of care that the medical profession rarely provided in the past.

Director of Therapy is Helen Cook.

COOK
People are wanting to think of lifestyle issues and what they can do to help themselves. Somebody said to me recently - Well how come if I was a cardiac patient, if I’d had a heart attack, I’d be given this whole rehabilitation regime, I’d be told maybe I needed to change my diet, I’d be given an exercise regime, why is it that after a diagnosis of something as kind of - as crucial as cancer that I’m not told to make any changes to my life? People come here in a great state of distress, sometimes trying to make very difficult choices, an experience I’ll give you - I saw a woman, not very long ago, who was 41, she was single, she didn’t actually have a great support network, she’d been told by her surgeon that she needed a mastectomy and was absolutely terrified about that idea and needed somebody to talk to about that. But meanwhile also she’d been to see a herbalist and I must say the majority of herbalists - I’ve never heard make such claims but this herbalist said - Well, don’t worry I can - don’t go for your surgery just yet I’ll give you some herbs and maybe you won’t even need to go for your mastectomy. The other difficult thing is she’d been talking to some of her family about it and been given 15 books, this is in one week, since she’d seen her surgeon. So she’d been to see a herbalist, been to see a surgeon, been given 15 - and came to us absolutely kind of on her knees trying to think of the most sensible and rational way forward. And of course we all know when we’re in stress we don’t make very rational or wise choices. So we were able to sort of sit down with her and go through with her the different options and give - just give her some of the kind of right information for her to make that kind of balanced choice that was right for her.

MICHELLE
The first day was just so incredible - just to be with other people who have no kind of judgement to be made of you or just being in a supportive atmosphere where you could learn from other people.

FORD
Which treatments do you think helped you most?

MICHELLE
It’s difficult to isolate them because they all came as a kind of package. But the issue around the diet I think is a very important one.

FORD
Did it change the way you ate a lot?

MICHELLE
Absolutely, absolutely. I read very quickly the issues about the move towards a more sort of whole food diet, move away from things that might hinder your recovery - things like dairy food, things like all the saturated fats, all that kind of thing. But that was the first step. From there I had a whole number of things, one particular sort of massage course - Shiatsu - which I found just incredibly powerful and very, very healing and very, very kind of centring in myself, helping me to feel just stronger and feel kind of able to - when you’re going through chemotherapy you just are so weak and just wiped out, to have somebody helping you to perhaps amass the energy that you do have and make you feel better was just incredible.

FORD
How long ago now is it that you were first told that you’d got cancer?

MICHELLE
It was in the October of 2000 - so it’s coming up for four years. I think you’re sort of considered to be cured after five years so well on the way.

BAUM
In my long career I have seen some of the most awful things.

FORD
Cancer specialist Professor Michael Baum has seen first hand the horror of what accepting advice which can lead to avoiding orthodox treatment can do.

BAUM
The worst, which I cannot - I still have nightmare visions of this was a youngish, in her thirties, African girl who came in moribund with advanced breast cancer. Her breasts had rotted away and was a stinking bleeding mess. She had also been adopting certain African traditional remedies as well, and she died within about 24, 36 hours of being admitted to hospital. And I saw on her body the stigma of what breast cancer must have been like in the days before there was any surgery. I saw another case, which was very rewarding in a way, it was an elderly woman who had a very indolent type of breast cancer which was being treated with carrot juice - a very popular high intake of carrot juice. And she was bright orange. I think she’d reached the point where she thought she ought to abandon alternative medicine. We stopped the carrot juice and I put her on tamoxifen and she was lucky and she - if you talk about miracles, this looked like a miracle.

FORD
Professor Baum voices the concerns of others involved in cancer care who fear that patients faced with a desperate diagnosis will search for alternatives hoping for a miracle. Today one of the first places they turn to is the internet. Earlier this year Katja Schmidt and Professor Edzard Ernst, published a study of websites offering cancer advice to patients and found that a significant number were promoting bogus cures or advising patients to avoid medical treatments like chemotherapy.

Of the anti-cancer products being offered - 118 of them across 32 websites - most had little or no direct clinical research behind them but were being offered as preventative or in some cases even curative treatments.

SCHMIDT
For instance people were very much advising things like the Gerson diet, let’s say, or various herbal products as well and different mind body therapies as well. Most of the websites are citing studies that are at a pre-clinical stage, at an early stage, and haven’t really been tested on humans at all. And they overtly discourage patients from using conventional cancer therapies. We found quotes such as: "Chemotherapy and radiation though known to be a total failure in the so-called war against cancer remain as the only therapies which enjoy federal mandate." Now if I read a statement like that it sounds very, very off putting and as a patient I would think they’re talking here about conventional therapies equals failure and I won’t be able to get any sort of cure out of them and I then I might look for on that website well what alternatives do they offer me. And we really think that is dangerous.

FORD
Not all websites came under fire from the report but one that was singled out was the "world-wide-healthcentre.net", which the authors said was making "ridiculous promises and claims" about cancer treatments. It’s founder, Dr George Georgiou, a practitioner of natural medicine based in Cyprus, says he’s just giving the 40,000 visitors a month he gets, honest information.

GEORGIOU
When you look at the information that is on the website there is nothing categorical. Firstly, I haven’t written all the information on the website because we also get papers donated from other practitioners - medical practitioners as well as CAM practitioners - from all over the world. These are vetted by myself or other scientific advisors. One of the papers was talking about the dangers of using radiation and chemotherapy for the treatment of cancer and there is a lot of evidence to suggest that that is the case and this was actually written by a medical doctor who had experience in this field and we felt that this was his opinion and this went up. I believe strongly that at the end of the day it is the patient that makes the final decision what type of treatment they want to follow and there are many cancer patients that have chosen natural remedies and have been cured and these are well documented in the literature.

SCHMIDT
Any sort of user of a health website should be looking for who owns the website, what sort of qualifications do they have and people make claims in there, do they cite - do they reference those claims - is there any book source or article source at the end of the article? Also is the website current and up-to-date? And how easy is it to navigate between different sites and how well is the balance really on that website - do they only talk in very negative terms, do they use very extreme language? And finally I would like to point out that there are things - so-called seals of approval - for instance the Health on the Net Code of Conduct which means that other - a group of medics have looked at that website and have approved of their content and that’s certainly something to look out for.

FORD
So the advice, as ever when using the internet, is ’patient beware’.

Over the last decade, research has shown that many therapies are not just safe but used alongside conventional treatments particularly with serious illness, can vastly improve the patient’s well being. Perhaps even, their condition. What’s needed is more research, further collaboration and less antagonistic divisions between CAM and medical profession. For Exeter herbalist Simon Mills, this means encouraging more openness between patient, CAM practitioner and doctor but also more honesty about the nature of medical advice and the limitations of treatments - complementary or otherwise.

MILLS
CAM, complementary medicine, does have to prove itself. Where a treatment might be less safe or where it is done outside conventional healthcare in a way that might threaten, for example, a life saving treatment then clearly complementary medicine does need to be checked. Bringing it together so that the complementary and conventional professional can work together as a team is to me the most obvious way of doing this, so that everyone is aware of what’s going on. The main problem, by far the main problem with complementary medicine at the moment is that patients are often living double lives - they will tell doctor one thing and ignore the fact that they’re taking complementary healthcare. The doctor therefore doesn’t know that this is happening. If only the patient was reassured that the doctor would not mark down their card, if the patient admitted to taking complementary medicine which is what they fear, if doctors were open to this and invited patients to tell them what was going on, and ideally then communicated with the CAM professional, then we would have integrated healthcare, that is the real goal.

FORD
Next week I’ll be looking at the present state and the future regulation of CAM, and asking if patients are adequately protected from bad practice.

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