miércoles, 15 de julio de 2015

Radical Remissions: Cancer Patients Who Defy the Odds


Medscape Medical News > Oncology
Radical Remissions: Cancer Patients Who Defy the Odds

Roxanne Nelson
July 08, 2014


According to statistics, Lola Baltzell should have died 3 years ago. Instead, she celebrated the fifth anniversary of her diagnosis of metastatic breast cancer by biking 110 miles to raise money for the Dana-Farber Cancer Institute in the Pan-Mass Challenge.

Not only is Baltzell still alive after 6 years when median survival is 3 years, her scans have been clear of cancer for more than 5 and a half years.

"You will never be in remission, you are a chronic patient, you will never be cured — that's what the doctors keep telling me," she said. "But every scan done after November 2008 has been negative."

Baltzell, a 53-year-old social worker and artist who lives in the Boston area, is constantly on the move. She bikes to work year round, no matter what the weather, curates art shows, has showings of her own work, and is an avid practitioner of yoga and meditation. She sees herself as strong and healthy, and is hopeful that she will continue to defy the statistics.

Baltzell's experience is not unique. Although it is neither typical nor common, it is not all that rare. There are thousands of cancer patients just like her, who have extended their survival way beyond the upper limits of the median or who are seemingly cured after a terminal prognosis.

These individuals, sometimes called exceptional patients, have begun to attract the attention of researchers who are interested in what, if anything, they are doing to heal themselves of incurable diseases or to improve their chances of being cured.


Spontaneous remission, as it is often referred to, caught the attention of Kelly Turner, PhD, when she was an undergraduate at Harvard University in Boston. "I was surprised how little research was being done by the medical community on these patients who had healed from cancer," she said in an interview. "Many of the patients had healed without undergoing Western medical treatment or, following its failure, they used other therapies to extend their survival."

It became the focus of her PhD thesis at the University of California, Berkeley. Dr. Turner's research involved a year-long trip to 10 countries to interview 50 holistic healers and scores of cancer survivors about healing techniques. Since that time, she has analyzed more than 1000 cases of spontaneous remission and written a book: Radical Remission: Surviving Cancer Against All Odds. Dr. Turner prefers the term "radical remission" because typically there is nothing spontaneous about these unusual cures. Most patients were actively doing something to facilitate healing.

In the course of her research, Dr. Turner identified more than 75 different healing factors that patients used to help heal themselves. Of these, 9 stood out and were used by almost all of the survivors. These key healing factors involved body, mind, and spirit interventions. Dr. Turner noted that she is just presenting research, not prescribing cancer cures.

"Some of the popular media outlets were trying to present this as a '9 steps to curing cancer' sort of thing, and I said no, you can't do that," she told Medscape Medical News. "This is not a 9-step program for getting well. These are just 9 factors that most of the survivors had in common."

"I am a researcher who is simply trying to get a conversation started about this important subject," she said.

Dr. Turner emphasized that this is preliminary, exploratory research. "My biggest hope is that we can bring radical remissions to the discussion table. I have put out the hypotheses and now they need to be tested in prospective trials."


Navigating False Hope

She came across her first case of radical remission about 10 years ago when she was working as a counselor at a major cancer center. Intrigued, she conducted a quick search of the medical literature and was surprised to find there were more 1000 cases reported in medical journals. "I wondered why none of the physicians I worked with had ever mentioned these," she said.

These were primarily case studies, but there was no information about how the patient managed to survive, she noted. "No one had asked the patients what they had done to heal," Dr. Turner explained.

Most of the cancer survivors she interviewed reported that their doctors never asked what, if anything, they were doing that might be helping them. They also said that no one was keeping track of them.

She specifically studied 3 categories of cancer patients: those who healed from their disease without the use of any standard/conventional medicine; those who were treated with standard therapy and, when it failed to work, tried other treatments that did help; and those who used conventional and alternative medicine at the same time to overcome a very serious prognosis (i.e., any cancer that has a 5-year survival rate below 25%, such as advanced lung or pancreatic cancer).

"Everyone has seen cases like this in their practice," Dr. Turner said, "yet few have ever investigated them."

One reason for that, she believes, is that physicians simply don't have the time and can't explain it. Another is that oncologists might not want to instill false hope in patients with advanced disease. Still, those are not good reasons to ignore these cases. "It is not only scientifically irresponsible, it is also foolish, since there is the potential to learn so much about how the body heals," she said.

Of the cases that she reviewed, about 85% have no evidence of disease on their medical charts. About 15% still have cancer, but their tumors have shrunk and have remained stable for years.

One example is a patient with stage III non-small-cell lung cancer. His tumors are still there but they have shrunk considerably and haven't caused him any trouble, Dr. Turner explained. He never received any standard treatment for his cancer; instead, turned to a form of energy work and kept asking his doctors for "6 more months" before beginning chemotherapy. Six months became a year, and now it's been 5 years.

"Every time he goes in for a scan, his doctors shake their heads and say that they don't understand it, but that whatever he is doing, to just keep on doing it," Dr. Turner noted.

The issue of false hope can be difficult to navigate. "It's tricky because you don't want to give people false expectations, but it's only false hope if it is false," she explained. "These people are true, and they have truly healed. We have to be careful how to discuss them, but it doesn't mean we shouldn't talk about them at all, just because we don't understand it."

By not studying these long-term survivors, she contended, "we are missing out on an opportunity to learn how cancer behaves and about the healing process. We can learn a lot by studying anomalies."

The 9 Factors


Although the cancer patients she analyzed used a number of strategies, there were 9 factors common to most of the patients.

The patients radically changed their diets, took control of their health, followed their intuition, used herbs and supplements, released suppressed emotions, increased positive emotions, embraced social support, deepened their spiritual connection, and had strong reasons for living.

Several of these factors applied to Baltzell; however, she didn't consciously think about how they were going to help her survive or extend her life. Baltzell had a mastectomy followed by radiation to the chest and the bone metastases in her hip. "They told me it was too late to do chemotherapy, and that they would save it until the 'end' in order to extend my life," she said.

She was a long time devotee of yoga and found the practice helped her physically and emotionally. She was on the mat every day, even right after her mastectomy. "I didn't do much that day, but I was on the mat," she explained.

Meditation, which she had started to practice 6 months before her diagnosis, also helped. "I thought I was going to die sooner rather than later," she said. "I saw the stats and they didn't look very good, but meditation really helped me get over that."

She explained that as her practice deepened in the weeks after her diagnosis and treatment, meditation helped her find peace and accept the situation. "I was okay either way and ready to go if that was going to be the case," she told Medscape Medical News. "I even told that to a friend that I was fine and I released the fear and attachment to life."

She had long wanted to get a dog but her physicians told her that it was not a good idea because caring for a dog required energy and time. "I took that to mean that my doctor was worried that I wasn't going to be around long enough to take care of my dog," she said.

After 2 years, she got a Chocolate Labrador Retriever, which has a lifespan of about 10 years. "I decided that I wasn't going to die before my dog," she explained.

Baltzell also embraced the great support she received from her husband and friends and, in 2009, dove head on into a long-term art project with her colleagues. It has since been completed and has been exhibited in several states, as well as in Russia.

Limited Research


There has been some research into the idea of spontaneous or radical remissions, although it is limited. In 1993, the Institute of Noetic Sciences published Spontaneous Remissions: An Annotated Bibliography, which catalogued the world's medical literature on the subject. It included references to cancer and a wide range of illnesses — from ulcers to injuries caused by gunshots. It is essentially the largest database of medically reported cases of spontaneous remission in the world, with more than 3500 references from more than 800 journals in 20 languages.

Some research in this area has been conducted by Moshe Frenkel, MD, from Integrative Oncology Consultants, who is a clinical associate professor at the University of Texas Medical Branch in Galveston.

"The issue of exceptional patients has been an interest of mine for over 20 years. I have met hundreds of patients that fit the criteria in the medical arena," he told Medscape Medical News.

He is currently summarizing data for a study of exceptional patients from a population registry in Israel and documenting "lessons as perceived by these patients about their unusual recovery." He plans to submit the research for publication.

In earlier work tracking exceptional patients, Dr. Frenkel found that they were not using complementary therapies to extend their survival. "That means they did not use a magic alternative medicine cure to obtain their recovery," he said. "In the current study, we have similar findings, but also additional points that were found in the previous study and were not emphasized enough."

In one study of 14 medically exceptional outcomes, Dr. Frenkel and colleagues found that the overarching theme was connections, both internal and external (Palliat Support Care. 2013:1-8). Internal connections include relationships with God or a higher power and with oneself. The external connections include relationships with friends and family, with the medical system (physician, nurses, and other staff), and with other patients.

In another study, Dr. Frenkel's team interviewed 26 exceptional patients (14 from the United States and 12 from Israel) and found that personal activism was a recurrent theme (Support Care Cancer. 2011;19:1125-1132). This involved taking charge and getting involved in the process of diagnosis and treatment and becoming more altruistic in their relationships with others. In many cases, this activism reflected a change in the patient's philosophy of life.

For Baltzell, cancer changed her life for the better. "I think the cancer introduced a sense of fearlessness in me," she explained. "I am grateful that it happened, as I would have been a completely different person — less engaged, less passionate. It really upped the ante for me."

She doesn't know why she has beaten the odds. She said she will continue to listen to her doctors and follow her own intuition.

Dr. Turner is continuing her research and following up with the 200 people she interviewed. She has created the Radical Remission Project Web site, where people can post their stories and share their experiences.

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