Non-lethal cancers, spontaneous remissions, people with genetic risk factors who don't get cancer in their lifetime - these things are neither mystical nor miraculous; they are medical facts. Yet, there are few subjects that make mainstream physicians more nervous or uncomfortable than the idea of cancers that cure themselves.
Most cancer treatments are doled out on the assumptions that cancer is: a) always aggressive and life-threatening; and b) that it won't get better on its own.
But how sound are these seemingly basic assumptions?
A recent letter to The Lancet dared to suggest that a particular form of breast cancer - ductal carcinoma in situ - may simply burn itself out in time (Lancet, 2002; 360: 1101). The authors noted that a local regression (in other words, spontaneous healing) of this relatively mild form of cancer was first described 70 years ago (J Pathol Bacteriol, 1934; 38: 117-24) and has also been noted in some textbooks (Rosen PP, Rosen's Breast Pathology, 2nd edn, Philadelphia: Lippincott Williams & Wilkins, 2002), but has otherwise been largely ignored by the medical profession.
The authors, scientists at the Western Australia Centre for Pathology and Medical Research, say that in their experience of six years of performing core biopsies of DCIS, they often discover microcalcification lesions - areas of breast tissue that were probably once cancerous, but where the cancer has burnt itself out. They are not sure if high-grade DCIS could burn itself out in the same way, but the mere existence of such lesions has profound implications for those attempting to devise appropriate treatments for individual cancers (see box, p 3).
Apart from the impact that it can have on the patient's life, treating non-threatening cancers provides a high 'feel-good' factor for doctors. Normally impotent in the face of this perplexing disease, doctors who get a good result with a low-grade cancer may feel as if they are achieving something, which adds to the illusion that we really are 'winning the war' against cancer.
Because of medicine's inability to distinguish between the life-threatening and non-threatening cancers, patients with a positive diagnosis are often given the full force of medical treatment: surgery, irradiation and drugs for cancers that might not have been a threat to their lives in the first place.
What's more, all conventional treatments further weaken the immune system - an important factor since immune competence may be an important aspect in encouraging spontaneous remissions.
Sometimes, a conventional treatment works - but no one knows why. While no one would wish to give false hopes of a spontaneous remission to someone suffering from cancer, the fact is that spontaneous remissions do occur - perhaps more often than we realise and maybe even without our ever knowing it. In fact, cancer can develop in the body, but be kept so well in check by our own biological processes that it will cause no ill effects whatsoever.
Prostate cancer is often a slow-growing condition that is not necessarily life-threatening. Other types of tumours, such as sarcomas, are also generally slow to grow.
Unfortunately, doctors are often ill-equipped to discriminate between slow-growing, less aggressive cancers and those that are aggressive and life-threatening. This is the 'X factor' that prompts doctors to advise regular screening programmes and, on detection of a potential cancer, swift treatment with chemotherapy and radiation treatment.
These slow-growing - and sometimes non-growing - tumours look the same as life-threatening ones under the microscope; they only behave differently in the body. The latest evidence suggests that regular screening is most likely to pick up these slow-growing, non-lethal cancers and lead to overtreatment that may actually increase death rates rather than reduce it (Arch Intern Med, 2000; 160: 1109-15; Lancet, 2001; 385: 1340-2, 1284-5).
Knowledge after death
Evidence from autopsies has taught us some amazing facts about cancer. These examinations regularly turn up otherwise undetected cancers that were not the cause of death. Undetected cancers, of course, make a mockery of the official cancer registries since, clearly, a sizeable proportion of cancers are never diagnosed. They tell us that the incidence of cancer is much higher than we believe it to be. They also tell us that cancer is not always a killer.
These undiagnosed cancers are referred to in the medical dialect as 'disease reservoirs'. When Swedish scientists spent a year of concentrated effort in an attempt to find all the lung cancer cases in the country, they discovered that the true rate of lung cancer in Sweden was 40-50 per 100,000, and not the 30 per 100,000 they thought it was. That's a significant 30-60 per cent 'reservoir' of undetected cancer (Lung Cancer, 2002; 37: 137-42).
Other studies have shown high rates of lung cancer only detected after death (JAMA, 1987; 258: 331-8; Chest, 1986; 90: 520-3). Reasons for the lack of diagnosis were in part because some elderly patients were simply too sick to undergo diagnostic testing for troublesome symptoms. But another reason was that patients showed no symptoms that betrayed the presence of cancer - and most were non-smokers, a group unlikely to be referred for lung cancer investigations in the first place.
Another Swedish study found that as many as 15 per cent of major cancers were not diagnosed before death, and around half of these were of a type normally considered fatal (Hum Pathol, 1994; 25: 140-5). In this study, the discrepancy between medical diagnosis in life and autopsy findings after death was higher in elderly patients, a finding that echoed an earlier Swedish study which concluded that undetected cancer in this older age group may be the result of undifferentiated symptoms such as weakness and fatigue as well as the type of tumours detected, which were often small and slow-growing (Nord Med, 1989; 104: 23-4, 29).
However, as some researchers have also discovered, cancer in older people is generally less aggressive than those in younger people - though no one is sure why (Int J Radiat Oncol Phys, 1982; 8: 1471-80; Cancer J, 1994; 7: 212-3; McKay FW et al., Cancer Mortality in the US, 1950-1977, NIH Publ No. 82-2435, 1982).
Other studies have found high rates of undetected colorectal cancer after death (Gastroenterol J, 1989; 49: 26-8) and, when US researchers reviewed autopsy studies of women not known to have breast cancer and who died from other causes, they found that 1.3 per cent of the women had occult (hidden) invasive breast cancer and 8.9 per cent had DCIS (Ann Intern Med, 1997; 127: 1023-8). Taken as a whole, such findings clearly have implications for what it really means to have cancer.
Why does cancer go away?
The mechanisms of spontaneous remission are by no means fully understood. The most popular theory is that some form of immunological reaction occurs, though this is still unproven (Onkologie, 1995; 18: 388-92).
There also appears to be a connection between extreme high fever and remission of cancer (Blut, 1990; 61: 346-9; Spontaneous Remission: An Annotated Bibliography, Sausalito, CA: Institute of Noetic Sciences, 1993). High fever in childhood or adulthood may protect against the later onset of cancer, and spontaneous remissions are often preceded by feverish infections (Neuroimmunomodulation, 2001; 9: 55-64).
Hypothyroidism may also trigger apoptosis (cell death) in tumours (Anticancer Res, 1999; 19: 4839-44). Yet another theory is that DNA methylation, which is involved in cell differentiation, may play a part in spontaneous cure (Mutat Res, 2000; 462: 235-46).
Finally, some believe that psychological factors have an influence (Zeitschr Psychosom Med Psychother, 2000; 46: 57-70). Today, this is not as far-fetched as it once seemed, given all we now know about stress and disease, and the way that the nervous system can directly influence the functioning of the immune system.
It's a miracle - or maybe not
Most of the information on spontaneous regression is the result of efforts by noetic scientists. Indeed, the standard work on the subject, Spontaneous Remission: An Annotated Bibliography (Sausalito, CA: Institute of Noetic Sciences, 1993), lists 1051 case reports published in the peer-reviewed medical literature. This compendium has much to tell us about spontaneous remission, and is also likely to represent only a small fraction of individuals who have not received conventional treatment, yet whose bodies have won the battle against cancer.
A simple Medline search for reports of spontaneous remissions of cancer (that is, remissions occurring without treatment or with inadequate treatment) produces a wealth of case reports on the subject from all over the world. Among the cancers reported to have remitted spontaneously are:
* adult T-cell leukaemia and/or lymphoma (Leuk Lymph, 2000; 39: 217-22; Blut, 1990; 61: 346-9)
* oesophageal cancer (Dis Esoph, 1999; 12: 317-20)
* lung cancer following coma as a result of myxoedema - dry, waxy swelling of the skin due to an underactive thyroid - (J Natl Cancer Inst, 1993; 85: 1342-3) and squamous cell lung cancer (Atemwegs- Lungenkrankh, 1995; 21: 536-8)
* liver cancer (Hepato-Gastroenterol, 1998; 45: 2369-71; J Hepatol, 1997; 27: 211-5)
* metastatic non-small cell lung cancer (Ann Oncol, 1997; 8: 1031-9)
* lung metastases from a cancer of the uterus (Zeitschr Onkol, 1997; 29: 87-8)
* scalp and/or lung metastases from a kidney carcinoma (Am J Clin Oncol Cancer Trials, 1997; 20: 416-8; Hong Kong Med J, 1999; 5: 72-5)
* bladder cancer (Eur J Surg Oncol, 1992; 18: 521-3)
* liver, spleen and peritoneal metastases following unsuccessful surgery for liver cancer (J Gastroenterol Hepatol, 2000; 15: 327-30), and lung metastases from a cancer of the liver (Pathol Int, 1999; 49: 893-7)
* metastatic malignant melanoma (Ann Plast Surg, 1991; 26: 403-6)
* large tumour of the mediastinum (chest cavity) (Ann Thorac Surg, 2002; 74: 1711-2).
What this means is that spontaneous remission not only occurs, but is well acknowledged outside of the miraculous and religious context in which it is so often shrouded.
Spontaneous regression of cancer is not a miracle, a fantasy or a medical fluke. It is a biological reality. If we were truly serious about curing cancer, we would be paying much more attention to this important phenomenon.
Shadows on the brain
One of the most recent studies on psychosomatic cancer therapy comes from Germany. Over the past 10 years, medical doctor and cancer surgeon Ryke-Geerd Hamer has examined 20,000 cancer patients with all types of cancer.
Dr Hamer wondered why cancer never seems to systematically spread directly from one organ to the surrounding tissue. For example, he has never found a cancer of the cervix and cancer of the uterus in the same woman. He also noticed that all his cancer patients seemed to have something in common: they had all experienced some kind of psychoemotional conflict prior to the onset of their disease, a conflict that had never been fully resolved.
On the basis of these 20,000 examinations, Dr Hamer has come up with some revolutionary information. In all of these cases, X-rays taken of the brain by Dr Hamer have shown a dark shadow somewhere in the brain. These dark spots are located in exactly the same place in the brain for the same type of cancer. There was also a 100-per-cent correlation between the dark spot in the brain, the location of the cancer in the body and the specific type of unresolved conflict.
These findings have led Dr Hamer to suggest that, when we are in a stressful conflict that is not resolved, the emotional reflex centre in the brain that corresponds to the experienced emotion (for example, anger, frustration or grief) will slowly break down. Each of these emotion centres is connected to a specific organ. When a centre breaks down, it will start sending the wrong information to the organ it controls, resulting in the formation of deformed cells in the tissues - in other words, cancer cells.
Dr Hamer also suggests that metastases are not the same as cancer spreading. It is the result of new conflicts that may well be brought on by the very stress of having cancer or of having to undergo invasive, painful or nauseating therapies.
When Dr Hamer started including psychotherapy as an important part of the healing process, he found that when the associated conflict was resolved, the cancer immediately stopped growing at a cellular level. The dark spot in the brain also began to disappear, and the diseased tissue came to be replaced by normal tissue.
According to Dr Hamer, research in Germany, Austria, France, the US and Denmark has confirmed his findings - that emotional conflicts create cancer, and solving the conflicts in question stops the cancer growth (for more information, see Dr Hamer's website: www.pilhar.com/English/NewMed/01NewMed.htm).
Pollution and aggressive cancers
The flipside of the question of why cancer suddenly disappears is, of course, what makes an otherwise slow-growing cancer suddenly spread. Some scientists believe that the answer lies in our environment.
When most people think of environmental agents, they think of how these agents can cause cancer. However, preliminary evidence from scientists at the Medical College of Wisconsin suggests that such agents can also act on already established cancers.
The researchers, led by Paul F. Lindholm, presented their findings at the 90th American Association for Cancer Research meeting, held in Philadelphia on 10-14 April 1999. They noted that aggressive prostate cancer cells were different in their genetic makeup from dormant cells, and that environmental pollutants such as heavy metals, cigarette smoke, pesticides, or car and truck emissions could trigger them to attack the surrounding tissue and, thus, spread more rapidly through the body. Furthermore, they also noted that these same pollutants could also turn non-aggressive prostate cancer cells into killer cells.
Their ongoing research is being supported by a grant from the Environmental Protection Agency (EPA). An Internet update on their progress can be found by following the links at: http://cfpub.epa.gov/ncer_abstracts/index.cfm/.
The human body is miraculous - more finely tuned and much more subtle in its reactions than we are generally able to appreciate or comprehend. We can't force the miraculous to happen. But, according to some authorities, we can create the environment in which 'miracles' can materialise. As so many cancer patients have been treated with powerful drugs, when cases of spontaneous remission do appear, it is difficult to tell what aspect of the person's life began to reverse the process.
For instance, was it the drugs or was it something altogether stronger within the individual? According to the American Institute for Cancer Research and the World Cancer Research Fund, keeping cancer at bay is a practical matter of diet and exercise (see box above).
Perhaps this attention to diet may also help to reverse the course of cancer. Or, according to pioneers such as Dr Ryke-Geerd Hamer, it is the ability to harness inner emotional and psychological resources and to resolve long-standing inner conflicts that make the difference. Anyone who takes seriously the responsibility of staying healthy must be committed to looking after both body and soul. This approach may provide the most useful key to reducing and reversing cancer in the modern world.