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209 CHAPTER 7 Unconventional Therapies Shortly after I was diagnosed with NHL, I started digging around on the Internet to try to find out my prognosis. The survival statistics I turned up were discouraging: they indicated that it was more likely than not that I’d be dead within the next few years. While my oncologist tried hard to sound encouraging, it was clear that she, too, thought the odds were stacked against me. We’ve become so accustomed to the miracles that modern medicine regularly performs, it can be a shock to discover that, even with the best of care, sometimes the disease wins. It was hard to go from being a young, healthy person, planning to have a baby and embarking on the most exciting part of my career, to realizing that I probably wasn’t going to survive the next few years. It’s not surprising that, like many people faced with such a bleak scenario , I wanted to learn about alternatives. Once I got over the shock of the diagnosis, I was determined to do everything I could to tilt the odds in my favor. I decided to participate in the rituximab + CHOP clinical trial, and, in this same spirit, I decided to investigate the options that nontraditional complementary therapies had to offer. Moreover, I was disgusted by the apparent lack of concern displayed by some of the medical professionals involved in my diagnosis. The first oncologist I saw laughed when he told me I had a tumor the size of a football and left me shivering in a hospital gown while he took a phone call setting up a poker game. His glib reassurances about the curability of Hodgkin lymphoma were no comfort once I was diagnosed with NHL. Like many Americans, I had heard that practitioners of complementary medicine were caring and compassionate. Additionally, having read extensively about herbal medicine years earlier, I was convinced that a treasure U 210 Treating Lymphoma trove of untapped knowledge about unconventional pharmacological therapies existed out there and could be useful. As a trained scientist, I hoped to be able to determine which of the unconventional approaches seemed the most promising. I have to admit that I ended up feeling disappointed with what I could find out about nontraditional approaches to cancer therapy. The main problem for me was the lack of solid scientific information about the efficacy of a given treatment. By solid scientific information I mean information obtained in controlled clinical trials. In a controlled clinical trial, a group of patients is given the treatment under investigation, and what happens to them is compared with what happens to a similar group of people given the best standard therapy available. In a correctly designed clinical trial, patients with similar conditions are randomly assigned to the two groups prior to treatment. This serves to avoid biasing the results in favor of one treatment or the other. Also, trials should include a large number of patients to avoid the types of statistical flukes discussed in Chapter 12. It’s also important to confirm the diagnosis of the people undergoing the trials pathologically and to have adequate follow-up and precise documentation of their response to treatment. Unfortunately, much information on alternative cancer therapies hasn’t been obtained this way (although this is now beginning to change). Many practitioners rely on anecdotal information based on their experiences with individuals outside a controlled setting. The problem with anecdotal evidence , such as “I knew a woman with lymphoma who started eating shiitake mushrooms and red grapes and has been in remission for twenty years,” is that we’re all individuals, with highly individualized circumstances. Occasionally people undergo spontaneous remissions. That is, there is no apparent reason for the remission. If a given woman went into remission after adopting a given dietary regimen, it’s possible that her dietary regimen cured her. It’s also possible that she had a spontaneous remission, having nothing to do with her diet. And even if the regimen did cure her, it’s possible that it was an idiosyncratic response that wouldn’t work for anyone else. From an anecdotal report, there’s no way of distinguishing between the various alternatives. It’s only when we find that large numbers of people exposed to the same regimen respond in predictable ways that we can begin to accept that approach as valid. This doesn’t mean that anecdotal evidence is bad. If I was convinced that a certain...


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MARC Record
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