Sometimes it's just a mystery why some cancer patients survive
IN PRACTICE
One man's grim prognosis leads him to try alternative treatment, despite his doctor's doubts. His remission raises more questions.
Just when I think I can predict a disease's deadly outcome, along comes someone to remind me how little we truly know about cancer. Sometimes, a patient survives against all probability, and I am left not knowing why.
"Sal Wittgen" (not his real name) was a poet. When I first saw him in my examination room, I noticed his shock of white hair and the wild look in his eye. Back in 1994, I discovered his liver tests were elevated then found he had hepatitis C, using the new blood test that had just become available.
His ultrasound showed that his liver had the beginnings of cirrhosis. A liver specialist prescribed the anti-viral treatment alpha interferon, but it made him fatigued and he quickly stopped it.
In 1997, when Sal was feeling fairly well, I sent him for a routine ultrasound of his abdomen that showed a mass in the liver. A liver biopsy revealed hepatocellular carcinoma, a vicious type of cancer that is very difficult to cure. Its five-year survival rate with conventional chemotherapy was only 4%. I suggested a liver transplant.
I won't survive it, Sal insisted.
Instead, he chose what was then a new kind of treatment: chemoembolization, in which chemotherapy is administered through the artery that feeds the tumor and then the artery is destroyed. Since 1997, this treatment has been used effectively for more than 1 million patients in more than 30 countries. But back in 1997, no one knew how well it would work.
His tumor shrank in response to the treatment, and though I kept waiting for the cancer to regrow and spread, his follow-up CT scans continued to be negative. But the hepatitis C virus continued to eat away at his liver.
Enough of poisons, Sal said. Instead, he turned to a heretical alternative medicine physician, Emanuel Revici, who was 100 years old and still practicing medicine.
Revici was born in Romania in 1896. He received a medical degree from the University of Bucharest in 1920. He moved to Paris, then Mexico City, where he began experimenting with drugs to treat cancer, then to New York in 1947, where he started the Institute of Applied Biology and conducted experimental cancer research. Professional cancer societies soon began to consider him anything but a scientist.
In the 1980s, he received more than a dozen patents for chemical formulations to use on cancer patients. But New York state soon challenged and restricted his medical license, and found him guilty of professional misconduct in 1988.
