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Thoughts on Alternative Treatments
This subject is very controversial, and we welcome opposing viewpoints, presented in a scientific manner.
The following is a message taken, with permission of the author, from the Braintmr list 2/16/98:
ROBERT A. FINK, M. D., F.A.C.S.
Neurological Surgery
2500 Milvia Street Suite 222
Berkeley, CA 94704-2636 USA
Phone: (510) 849-2555 FAX: (510) 849-2557
My basic position on the Burzynski (and other "non-orthodox" treatment) issue:
So far as I am concerned, this is my "last word" on the subject unless people specifically *ask* me for my opinions.
BURZYNSKI ET AL, MY BASIC POSITION
With the recent repeat run of questions regarding the Burzynski
treatment ("antineoplastons"), I have experienced a new set of flames
by certain members of this List. My responses to those flames, if
any, have been made to the individuals and have not been posted to the
List. I thought, however, that it was time for me to write a little
note here about my attitudes towards "alternative therapies" and
people like Dr. Burzynski.
I am a scientist. What I know about the treatment of disease is based
on research done by myself and others and part of many years of
scientific labors by many people. I have seen many positive changes
in the treatment of brain tumors and other neurological disease/injury
in my 30-plus years of work in this field. I also realize that there
are still far too many conditions that we cannot cure (gliomas, brain
stem tumors, and other conditions). I am confident that, with the
advance of science, we will eventually have answers to these currently
incurable conditions. In the meantime, our job is to alleviate
suffering as much as we can.
I am not a neurosurgeon for the money. Most of my colleagues in
medicine feel the same way. Yes, we get paid for what we do; indeed,
everyone must earn a living in order to support onself and one's
family. Some physicians make a great deal of money, but those who do
usually do so because they put in long hours and much effort into
their practices. Even those of us who are wealthy (and I am not one
of these!) do not approach the incomes made by some entertainers,
sports figures, and others who some might say do less to earn their
incomes.
I do not begrudge any physician the ability to make a good income. On
the other hand, I have never refused to care for a patient because
they could not pay; and I have certainly not made a patient pay me
simply for going over some records to decide if I would accept them in
my care. When doing research (and I have done my share), I have
always done that work with an affiliation to a major University or
other teaching institution, and the work was supported by grants,
either Government or private in origin. Patients were not charged for
treatment which was experimental or research-oriented. I do not
believe that it is ethical for patients to pay for treatment which is
experimental and I do not support people who profit from experimenting
on patients.
There have been many instances where people have advocated new
therapies for "dread" illnesses. In the late 1950's when I was a
medical student, my best friend, a young man who was but 20 years old,
was stricken with testicular cancer and, after surgery and the
state-of-the-art treatment for the time (testicular cancer is now
highly curable with modern chemotherapy), he subjected himself to a
treatment called "Krebiozen", a substance developed by a man whom was
later shown to be a charlatan. Sadly, this man attracted the interest
of Dr. Andrew Ivy, a Nobel prizewinner from the University of
Illinois, and, by connecting Dr. Ivy's name with Krebiozen, succeeded
in profiteering off of hundreds of thousands of cancer sufferers
before "skipping the country" with his ill-gained millions, leaving
his patients with their disease. Many of these "miracle cures" had
their "testimonials" (of long survival or "cure"), but careful
scrutiny, using scientific methods of laboratory analysis often proved
that there was no cancer to begin with in the "cured" patients.
Sadly, in the case of my friend, after his parents depleted their
savings for the Krebiozen, Malcolm died in pain at our University
Hospital, barely after completion of his sophomore year in medical
school. Our graduating class yearbook was dedicated to him.
When scientists criticized the nonscientific aspects of Krebiozen and
also criticized the financial aspects of Dr. Durovic (the "inventor"),
people literally "came out of the woodwork" to accuse "organized
medicine" of trying to "block a new treatment" because such treatment
"would cost the medical establishment money". This is a common thread
among those who espouse these "new cures" with almost religious zeal.
When Dr. Durovic left the country with his money (and Dr. Ivy was
disgraced), the "testimonials" stopped.
In the seventies and early eighties, another "miracle cure" came
around. This one was "Laetrile", an extract made from apricot pits,
which contained a small amount of highly toxic cyanide. It was later
called "Vitamin B-17" to avoid inclusion as a drug by the FDA. When
Laetrile was finally tested by independent laboratories, it was found
that many specimens contained no active ingredients, while other
specimens contained levels of cyanide which, in children, could be
very toxic and even fatal. Laetrile was sponsored by a Dr. John
Richardson, whose practice was right in the next town from where I
practiced as a neurosurgeon, and Dr. Richardson's patients came from
all over the country to receive the Laetrile injections. Dr.
Richardson had a deal with a local motel where the patients stayed,
and there was hardly a week when one or more of these patients, often
from a long distance away, would be brought to the Emergency Room of
our hospital in a terminal condition from rapid spread of their cancer
(Dr. Richardson could never qualify for hospital privileges and could
not admit his patients to the hospital). I cared for some of these
patients during their terminal stages (many of them had metastases to
the brain and/or spine), and they all said that they were "cured" by
the Laetrile, and that what was going on at the time was due to
"something else". I also, interestingly, ran into several patients
who developed non-cancer-related conditions while in the area for
Laetrile treatment; and, while they were receiving care for that
condition, tests revealed that there was no evidence of any cancer, or
that cancer had ever been present. I was never able to obtain biopsy
evidence from Dr. Richardson in those cases.
Dr. Richardson eventually, I believe, ran afoul of the legal
authorities (I am not sure whether it was medicine-related or
tax-related), but he eventually closed his practice and I believe he
died some years ago. When the FDA and other University facilities
attempted to test Laetrile, no beneficial effect was ever found (when
the patients actually had proven cancer), and the potentially toxic
effects were substantiated. I still occasionally hear of someone
touting this substance, but it is no longer a major player in
"alternative medicine".
The common thread in many of these "miracle cures" is the following:
- The method or "treatment" is *proprietary*; i.e., offered only by
one person or institute.
- It costs a lot of money and payment is usually required to be "up
front".
- The work is not being done through an established University or
Government grant. Such work (through Universities or grants) is
usually free to the subjects.
- The publicity for the work is mainly through "testimonials" and not
in accepted, peer-reviewed scientific journals. I recently reviewed
some work published in an overseas journal about a new method of
treatment of another "dread disease" (Parkinson's disease) and found
that the "new method", being advanced by a proprietary researcher, was
available only at the researcher's proprietary facility and was very
expensive. There had been a number of articles in this journal
attesting to the validity of the work, but when I finally got a copy
of the journal in question, I discovered that it was owned and
published by the researcher himself, and that he was the basic "peer
review" person!
- If anyone attempts to question the motives of the proponents of
these new "cures", the responses from the "testimonial people" are
vigorous. We (the critics) are merely trying to "preserve the profits
of the medical establishment" and we are persecuting Dr. A or B
because he is threatening us (in orthodox medicine). It is a
"conspiracy" to prevent a new cure from being brought to the public.
Why are people so quick to question the motives of scientists? If
someone found a cure for cancer tomorrow, don't you think that most of
us wouldn't immediately start using such for our patients as soon as
it was shown to be safe and effective. That's what research is all
about.
There are many diseases and conditions which, to date, are incurable.
I cannot cure glioblastomas, brain stem tumors, metastatic melanomas.
All of the orthodox medical armamentarium to date is useless against
these tragic conditions (for cure; we can certainly help temporarily).
When a patient wants to try "alternative treatment" under such
conditions, I never attempt to block such, as long as they also
consider the traditional treatment which may be helpful and which will
not cause unnecessary pain or harm. The destruction of a family's
financial resources (by an expensive, unproven treatment method) is
just as severe a side-effect (for the family) as is a reaction to
toxic chemotherapy or radiation damage.
If therapies such as Dr. Burzynski's "antineoplastons", Essiac tea,
shark cartilage, angiogenesis inhibitors, immunotherapy, etc., have
value in the treatment of brain tumors, then it will be shown through
scientifically-valid research. Such research will be financed by
grants, either private or public, and not by the savings of
middle-class and poor families who are desperately trying to salvage a
few weeks or months of life for themselves or a loved one. I would
not take my family to many of these schemes (nor would I accept them
myself); and I would advise my patients to avoid some of these as
well. If I am asked for my opinions concerning these "cures", I will
give my honest responses, flames or no flames. And I will not be drawn
into a "game" of invective and "blame" by the devotees. As I have
said before (and others disagree), medicine is a science, not a
religion, and the eventual cure for malignant disease will come from
scientific fact and not from "belief"!
All best,
Bob
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"Ex Tristitia Virtus"
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