Respectful Insolence

Starchild Abraham Cherrix: It’s over

Sadly, Starchild Abraham Cherrix is almost certainly doomed:

ACCOMAC, Virginia (AP) — A 16-year-old cancer patient’s legal fight ended in victory Wednesday when his family’s attorneys and social services officials reached an agreement that would allow him to forgo chemotherapy.

At the start of what was scheduled to be a two-day hearing, Circuit Judge Glen A. Tyler announced that both sides had reached a consent decree, which Tyler approved.

Under the decree, Starchild Abraham Cherrix, who is battling Hodgkin’s disease, will be treated by an oncologist of his choice who is board-certified in radiation therapy and interested in alternative treatments.

The family must provide the court updates on Abraham’s treatment and condition every three months until he’s cured or turns 18.

“It’s all over. It’s everything we fought for, everything we wanted to ever have, we’ve won. We got our freedom back,” Abraham said outside the courthouse after the hearing.

Tyler emphasized that the decree states that the parents weren’t medically neglectful.

Abraham said that he saw the doctor last week, and the doctor assured him that his cancer is curable. The teen said he’ll continue following an alternative herbal treatment called the Hoxsey method as well as his doctor’s treatment plan. The regimen won’t include chemotherapy, but radiation is a possibility, he said.

Video of the story can be found here and here.

It just goes to show that Board certification doesn’t necessarily guarantee adherence to evidence-based medicine. If this new oncologist truly believes that Abraham can be cured with the Hoxsey therapy, he’s gone pretty far off the rails of his profession. I do note with interest that he is not a medical oncologist (the kind of oncologist that gives chemotherapy) but rather a radiation oncologist. Don’t get me wrong. I’m not bashing radiation oncologists. I like radiation oncologists. I even spent nearly three years in the laboratory of a radiation oncologist doing research, a man for whom I have nothing but the utmost respect. The reason I like radiation oncologists is because they are a lot like surgeons (except for their way more civilized working hours) in that they are very good at treating local cancers. Consequently, they tend to think a lot like surgeons. (They do, however, tend by and large to have cooler toys, though.) Unfortunately, what Abraham clearly needs is systemic treatment (treatment of the whole body), and that’s not what radiation oncologists do, any more than that’s what surgeons do. Also, I’m quite curious who this doctor is and am rather puzzled that his name isn’t mentioned in the story. In his interview, Abraham says that this mysterious doctor offers “immunotherapy” in addition to radiation therapy. (He also shows evidence of the magical thinking that I discussed earlier when he compares Hodgkin’s lymphoma to a cold or a fever that he just has to get rid of, although he does acknowledge that it will be “difficult.”)

Curious, I did a little Googling and made a guess. It turns out that my guess was correct. In any case, the mysterious radiation oncologist is: R. Arnold Smith, M.D. (also mentioned here). Here is the tale:

Smith’s clinic employs immunotherapy, an innovative treatment that works to restore the immune system that age and cancer break down, helping the body fight back.

Combined with radiation therapy to debulk cancer, molecular targeted therapies to arrest host defenses, genomic assays, and chemotherapy when necessary, immunotherapy helps patients live a higher-quality, longer life, the oncologist says.

Today, after the short hearing, the judge looked at Abraham and said, “God bless you, Mr. Cherrix.”

Greenwood Leflore Hospital has prepared for the onslaught of national media because Cherrix’ s case has been featured on major all-news stations, including CNN.
Shannon M. Melton, marketing/communications director for the hospital sent an e-mail to all hospital directors Tuesday telling them to prepare for the VIP patient.

This morning, Melton declined to identify or confirm the patient and referred all questions to Wilson Gaillard at the Cancer Center.

Every door of the hospital will be manned by security guards, she said.

“We plan to bring in additional support from the police department, if necessary,” the memo states.

Gee, you don’t think that Dr. Smith’s clinic will get a huge influx of new business from this, do you? Dr. Smith will be offering the young Cherrix the following treatments:

Dr. Arnold Smith was awarded a method patent for his application of Interleukin 2 to create a factory for natural killer cells. This treatment appears to be a significant innovation and advance. Interleukin 2, when injected subcutaneously, has been known for some time to produce a firm nodule often called an “injection site nodule.” These nodules, we believe, are composed of significant colonies of clonally-replicating natural killer cells.

Additional daily injections of Interleukin 2 are best exploited if they are given by injection just on the periphery of the nodule or plaque. Our current policy is to “grow” the initial nodule by progressive injections until a sizable plaque is created, measuring 8-10 cm in diameter. It becomes slightly inflamed, hot, swollen, sore, and red. The plaques are not very painful, but have occasionally contained areas of skin necrosis which have always healed completely.

It may be that use of Cimetidine, antioxidants, and replacement hormones facilitate the production of these plaques to a significant degree. We have seen several patients with lung cancer and colon cancer who have shown progressive decline in Carcinoembryonic Antigen after Interleukin 2. Belly Plaques were created and sustained.

I looked for articles in the peer-reviewed scientific literature published by Dr. Smith about this technique, but there was nothing in Medline more recent than the 1990’s that I could find and none of it was about IL-2. However, Dr. Smith did list a number of publications on his CV on this technique in a journal I’ve never heard of before, Bulletin of Urgent and Recovery Medicine, a website for which I’ve been thus far unable to find. Looking at his CV and publication record, it appears that sometime around 1998 or so his publications stopped being mainstream and moved into this new “immunotherapy” and “anti-aging” medicine.

It is true that IL-2 is used for melanoma and renal cell carcinoma. It can actually be fairly nasty stuff, with a lot of side effects, including capillary leak syndrome, hypotension, and acidosis. It’s also not all that effective, with perhaps a 20% response rate, but, unfortunately, for refractory tumors like melanoma and renal cell carcinoma, it and interferon are about the best we have. Sadly, no evidence is presented that Dr. Smith’s method does anything other than raise a really nasty looking wheal on the abdomen. He has posted a provisional patent application, but I’ve failed to find an actual patent yet on the U.S. Patent and Trademark Office website. In addition, Dr. Smith’s website is long on testimonials but short on data (for example, he claims that there are a lot more natural killer cells generated but never actually shows any data that there are), preferring instead vague platitudes about immunotherapy like this:

When the immune system is weakened by old age, environmental causes or other factors, it can be more easily overwhelmed by cancerous cells. Cancer begins to occur when the immune system can no longer defend against invading tumor cells. There is evidence that in many cancer patients that rebuilding the immune system slows down the growth and spread of tumors.

Immunotherapy works to help restore the immune system that age and cancer break down, giving your body strength to fight back. By combining this treatment with chemotherapy, surgery and radiotherapy, Dr. Arnold Smith is helping more and more cancer patients become cancer survivors.

Or, get a load of this:

If Immunotherapy works so well, why isn’t everyone using it?

One reason is that researchers are used to dealing only in easily measured data, and subjective quality of life benefits are hard to precisely quantify. Conventional medicine can sometimes be slow to embrace new methods, but Steven Rosenberg, M.D., chief of surgery at the National Cancer Institute, is working to civilize the treatment of cancer, and his stratagem is immunotherapy. “Immunotherapy uses the body’s own immune system, a system that evolved to detect exquisitely small changes in molecules to tell non-self from the body, to fight cancer. If we can take advantage of that system, we’re more likely to have a treatment that is effective and carries minimal side effects,” says Rosenberg.

Another reason is that because many of these natural supplements that we find so beneficial are unpatentable. This means that pharmaceutical companies do not want to go the major expense to fund a study for FDA approval when they will not be able to have a proprietary drug to bring in revenue to offset the cost of the study.

Woo.

I particularly detest that Smith’s dragged Steven Rosenberg into this. I’ve met Steve Rosenberg on a couple of occasions. He is a giant among surgeons as far as surgical research goes. But, to give the real answer why everyone isn’t using immunotherapy, I’ll just say: Because it’s difficult and has been disappointing in its results in clinical trials. Immunotherapy was all the rage in the late 1980’s and early 1990’s. All sorts of investigators were injecting cytokines and taking out T-cells, activating them, and reinfusing them. Some of these therapies were really toxic, necessitating ICU monitoring to use. The real answer to the question is that we just don’t understand the immune system well enough yet to have truly effective immunotherapy with an acceptable toxicity profile.

I have to say, I find it rather odd that Abraham would pick a therapy that is guaranteed to result in large painful welts on his abdomen using a cytokine that is not without side effects all because he’s so adamant that he doesn’t want to suffer the side effects of chemotherapy again, but I’ve given up trying to understand his thought processes. Instead, I’ll just wish him well and hope that I’m wrong. I certainly don’t want him to die, but I’m afraid that this judicial decision has made that all but inevitable.

I suppose that this settlement is about the best that could be hoped for, given Abraham’s age and tenacity. It wouldn’t have been practical to tie him down and force him to undergo chemotherapy, and, given the immunosuppression that the chemotherapy would cause, any injury he might suffer resisting could have dire consequences. Sadly, this decision won’t save Abraham’s life, nor will it get him to see reality. Abraham’s invested far too much in his quest now to easily be persuaded that he’s made a huge mistake. On the other hand, I’m somewhat reassured that Abraham will be followed by someone who is at least nominally able to provide conventional care, even if this Dr. Smith does appear to be deep into woo of the immunotherapy variety as well. Perhaps if Abraham’s tumors keep growing he’ll finally realize that what he is doing isn’t working before it really is too late, but, for all we know it may be too late already. We can only hope that it’s not. I’m also heartened that Abraham has agreed to radiation therapy, at least in principle. He’ll very likely need it before the end to shrink those tumors in his neck before they start obstructing his windpipe or esophagus. Accepting radiation for local therapy may save him the indignity of a tracheostomy or a feeding tube, and there is value in that, even if it does come at the price of xerostomia.

Through all this, I had continued to hope against hope that Abraham would sooner or later realize the mistake he is making, but it’s become quite clear that he won’t and that he still thinks that he can beat his tumor using the Hoxsey therapy and whatever other stuff his new radiation oncologist plans on giving him. All I can do now is to wish him the best of luck with his cancer and the best of times during the little time he has left to live in this mortal coil–and hope that I’m wrong.

It’s very unlikely that I am, though.

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Comments

  1. #1 Jonathan Dresner
    August 17, 2006

    Another reason is that because many of these natural supplements that we find so beneficial are unpatentable.

    It just clicked: that’s a very common argument among alternative practitioners, trying to explain away the lack of research, but it’s wrong. It’s entirely possible for people to patent “traditional” techniques and substances, if nobody gets there first and there’s even a modicum of originality or processing involved. It’s no trick whatsoever for “Big Pharma” to take “natural” substances and repackage them in purified forms, or do a little selective breeding or GM and produce an “unnatural” variant with a higher concentration, and patent the gene codes, etc….

    The problem isn’t money; it’s the lack of evidence.

  2. #2 Andrew Dodds
    August 17, 2006

    Jonathan –

    There are also the ethical implications of refusing to properly test a treatment that you are sure is highly effective against cancer. This isn’t a matter of money – it is a matter of literally millions of lives.

    If the treatment works, of course.

  3. #3 Jurjen Smies
    August 17, 2006

    “By combining this treatment with chemotherapy, surgery and radiotherapy, Dr. Arnold Smith is helping more and more cancer patients become cancer survivors.”
    In the same way that painfully artificial breakfast cereal X makes up part of a nutritious breakfast otherwise consisting of whole wheat toast, eggs, fruit, milk, etc.

  4. #4 valhar2000
    August 17, 2006

    Well, if Abraham is willing to die for his beleifs, there is not much that can be done. He will be proved wrong, and perhaps his death will serve to dissuade other who would walk this path.

  5. #5 Orac
    August 17, 2006

    Well, if Abraham is willing to die for his beleifs, there is not much that can be done. He will be proved wrong, and perhaps his death will serve to dissuade other who would walk this path.

    The problem is, he doesn’t really think he’s going to die, as his statements to the media make plain; he thinks this stuff will cure him. Even when he does acknowledge the possibility of death, he has no conception of how nasty death from lymphoma can be. He seems to think that, if he dies, he’ll remain pretty much as he is now and just drift off to sleep, rather than becoming progressively more debilitated and possibly suffering intractable pain.

    Unfortunately, you’re also wrong about his death dissuading many to walk the same path. Alties are great at rationalizing failure. When he dies, just watch. They’ll be blaming the one round of chemotherapy that he did get, or they’ll be blaming the delay and the stress of the legal battle against fascistic (or is it “microfascistic“) medicine for delaying his “true” treatment.

  6. #6 quitter
    August 17, 2006

    Orac,
    Doesn’t this sound like human experimentation to you? I’m still a lowly med student, but I was unaware that without IRB approval and a approved research protocol that you could just shove different chemicals into people and tell them it’s a treatment.

    Isn’t this doctor behaving in a fashion that is supremely unethical? Isn’t this just unapproved human experimentation? It would essentially have to be because any approved protocol would require the doc to provide the standard of care, and his experimental treatment on top of it. Which would mean chemo + altie, not just altie. The doc in this case should probably have his licence taken away if he really is treating patients this way.

    Anyway, I agree that this kid is as good as dead and that won’t convince the alties of anything due to the cognitive dissonance involved, but according to the guidelines of the American Pediatric Association he’s long been old enough to make this kind of decision for himself. Just because it’s a stupid decision that will kill him, that doesn’t mean he doesn’t have a right to make it. If we lose our right to make decisions if the decisions we make are stupid, then we don’t really have the right to decide anything except to agree with our doctor.

  7. #7 Corkscrew
    August 17, 2006

    I can’t find a reference, but I remember Prof. Wiseman giving a talk about debunking mysticism, and one of the examples he mentioned was “faith healing” of snakebites.

    The story was: a bunch of gurus claimed that they could use their mystical powers to heal snakebites. Wiseman asked if they’d engage in a test; they agreed. The test involved allowing a poisonous snake to bite a small dog, then setting the gurus loose on it. Wiseman and co. videoed the entire two hours or so that it took the dog to die despite the gurus chanting over it. Its eventual demise nearly caused a riot among the spectators, who finally realised that they’d been duped by the gurus.

    It occurs to me that the only possible way to break the power of these quacks would be to take a similar approach. Find one of their victims who’s just started taking their potions and ask for permission to interview and/or videotape them at regular intervals. Once they die, broadcast the entire thing, showing their slow deterioration in graphic detail.

    It’s sad, but I think it would take something like that to convince these people that they’ve been betrayed.

  8. #8 anonimouse
    August 17, 2006

    quitter, sadly, makes the point I’ve been making all along. The argument cannot be “by choosing woo treatments he’s not capable of making his own decisions”.

    That being said, I am perplexed as to why Cherrix would consider “immunotherapy” treatments with pretty nasty side effects and avoid chemotherapy. Having had a relative go through a long round of interferon for Hep C, I can tell you that it is probably comparable to chemo in terms of the nastiness of his side effects.

    That’s why me thinks that this doctor’s just going to rubber stamp Cherrix’s Hoxsey treatment and give him palliative radiation when the tumors get too big.

  9. #9 The Ridger
    August 17, 2006

    I guess I was just lucky, but the only side effect I had from six courses of chemo was losing my hair. Yes, I had to take something else to prevent nausea – but it worked. I was never sick. I was a bit tired, and my oncologist didn’t want me going to work because my white cell count was way down, but since I have good benefits I got paid the whole time I was off work, so that’s not a negative side effect.

    Reading about those side effects he’s chosen makes me glad I had chemo. (Oh yes, the being cured part helps, too. Though my cancer was different than his, I acknowledge.)

  10. #10 Bardiac
    August 17, 2006

    I think Cherrix should have the right to refuse treatment.

    But the judge saying “God bless you” to him is just weird; it just sounds like the judge may have made his decision based on faith rather than legal precedents, laws, or logic. Would the judge have reached the same decision if Cherrix were Wiccan rather than Christian?

  11. #11 wintermute
    August 17, 2006

    It’s entirely possible for people to patent “traditional” techniques and substances, if nobody gets there first and there’s even a modicum of originality or processing involved. It’s no trick whatsoever for “Big Pharma” to take “natural” substances and repackage them in purified forms.

    You mean like how people used to chew willow bark for headaches, and now we have aspirin? Or maybe digitalis for heart attacks…

    In fact, “natural”-based compounds probably account for the vast majority of medicines.

  12. #12 Martin Ballzer
    August 17, 2006

    This is actually a perfect human experiment:

    1. If young Abraham does die, then it greatly supports Orac’s hypothesis.(chemo good, woo bad)

    2. If young Abraham recovers, then it greatly undermines Orac’s hypothesis.

    Why all the handwringing? Just let it play out. Abraham, his parents, the court, the child protective agencies, Dr. Smith should have their answer in a year or so on whether they took appropriate action or irresponsible neglectful action.

    In fact, if young Abraham survives and thrives, Orac should be the first to admit that his hysteria was ill-founded.

  13. #13 medrecgal
    August 17, 2006

    For Mr. Ballzer above, re: “if young Abraham survives and thrives, Orac should be the first to admit that his hysteria was ill-founded”… How is a civilized discussion of conventional medicine vs. alternative medicine a form of hysteria? Science says there is always going to be the occasional statistical oddity where an unproven treatment appears to work, while most of the time it fails. Orac is simply trying to point out the value in allopathic, scientifically based medicine as opposed to potions, crystals, alternative therapies and magical thinking. I’m not one to bash alternatives that are sometimes used in CONJUNCTION with standard medical care (for instance chiropractic or acupuncture), but to rely on something as untested, unproven, and un-mainstream as immunotherapy calls their values (ALL of the Cherrixes)into serious question. Yes, he may have had one failed course of chemo, but even allopathic medicine isn’t 100% perfect. We are human, after all.

  14. #14 Dianne
    August 17, 2006

    IL-2. Oh, lordy. If Cherrix thought chemo made him feel bad, wait’ll he finds out how he feels on IL-2.

    Unfortunately, he is very likely to die. Even more unfortunately, if he does survive we can’t conclude that the Hoxsey treatment works, make medical oncology obsolete as a specialty, and all retire to the beach for the duration. Occasionally, cancer patients have spontaneous remissions. More frequently, the progression of the disease is uneven and a patient may do well for weeks or months, only to suddenly degenerate at some point. That’s why one has to do clinical trials on large populations, to distinguish the workings (or lack thereof) of the treatment from random flucutations in the disease.

  15. #15 Hyperion
    August 17, 2006

    I honestly just don’t get alties. Ultra-religious woo at least makes a certain amount of self-referenced sense, in that there’s usually some ancient tradition, not to mention tribal enmities, at stake.

    I mean, I have a much easier time understanding Masada, compared to understanding this case. Similarly, at least refusing blood transfusion for religious reasons has a self-referenced reason, even if I disagree with the reasoning. Altie beliefs are just as zealously held and stridently defended as any religion, but there doesn’t really appear to be any common history or literature or scholarship involved, no communal holidays or worship centers, and not even any code of some sort to follow. It just sort of seems to be random brain farts and conspiracy theories that seem designed solely to increase human suffering and raise healthcare costs across the board for the rest of us.

    Then again, has anyone noticed how the rise in altie-woo has coincided with concern over BSE in the food supply? Am I the only one who considers them related?

  16. #16 Ruth
    August 17, 2006

    And many patients who reject some treatments for religious reasons will make rational choices outside of that. Some patients at the cancer center where I worked were Jehovah’s Witnesses and refused blood transfusions, but would take Procrit to boost their blood counts. They had chemo and radiation and recovered.

  17. #17 Peter
    August 18, 2006

    Jehovah Winess’s know very well that blood tansfusion’s save lives. They don’t hold any illusions of miracle or faith-based cures. They refuse them because they believe that getting a blood transfusion damages their chances of getting into heaven. ( Although I think their terminology may be different ) From their point of view it’s better to die than to risk their place ( or that of their child’s ) in the after-life.

    As to Cherrix…. What could we have expected? The reality is that Abraham Cherrix can’t be forced to undergo Chemotherapy. All this immunotherapy and Hoxsley cure stuff distracts I think from the main issue with Abraham. He truly believes that another more intensive round of chemotherapy will kill him. He went through one round, it didn’t work and it left him horribly weakened and thinking he was going to die. Then the oncologist ordered a second more intensive round of chemo. Abraham balked. Every report I’ve read suggests that he believes that more chemo will kill him. With that belief even a snake oil like cure like Hoxsley begins to sound good.

  18. #18 etbnc
    August 18, 2006

    Insightful analysis, Peter.

  19. #19 Roger
    August 18, 2006

    Actually Abraham has been told by oncologists that the high dose chemo would probably kill him. That’s hard statements to ignore guys. When Abraham is better you all will see. Thank goodness most of the people are sending Abraham positive words instead of doomsday messages such as you all.

  20. #20 HCN
    August 18, 2006

    Roger said “Actually Abraham has been told by oncologists that the high dose chemo would probably kill him. ”

    So where did this weird little tidbit of information come from? Because according to the Washington Post here:
    http://www.washingtonpost.com/wp-dyn/content/article/2006/07/25/AR2006072500945.html … with a quote from young Master Cherrix:
    begin quote
    “I truly believe that this massive dose of chemo and radiation would finish me off completely,” Cherrix, now 16, said yesterday, describing the further treatment his doctors prescribed.
    end quote

    And further this bit:
    begin quote
    A pediatric oncologist at Children’s Hospital of the King’s Daughters in Norfolk recommended chemotherapy and then, if needed, radiation.
    end quote

    Roger if you are going to make a statement like that, please back it up with something.

  21. #21 Orac
    August 18, 2006

    Actually Abraham has been told by oncologists that the high dose chemo would probably kill him.

    Really?

    How do you know this? Do you happen to know Abraham? Did he himself tell you this? Certainly, he’s never said this to the media; what he has said is that he believes that chemotherapy would kill him. He’s never said that oncologists have said that. In fact, given that he is a young, otherwise healthy young man, he would be the most likely to make it through the chemotherapy OK.

  22. #22 J. Thornton
    August 18, 2006

    Actually his chances are quite good. Although Abraham may not see it that way. How low does the chance of survival go to be defined as terminal, anyone know?

    “Without knowing the exact details of his treatment so far, it’s impossible for outsiders to figure what Cherrix’s chances are. Cherrix’s lawyer, Barry Taylor, says a local oncologist who reviewed the case file estimated Cherrix’s chances of long-term survival at about 25 percent if he takes more chemo.”

    http://www.fortwayne.com/mld/newssentinel/news/editorial/15277472.htm

  23. #23 Orac
    August 18, 2006

    And anyone want to bet that that local oncologist is Cherrix’s expert witness and would therefore be chosen to provide the low estimate of his chances of survival? In general, for relapsed Hodgkins, the odds of survival with high dose chemotherapy and stem cell transplant are between 35-65%, depending on the characteristics of the tumor.

  24. #24 J. Thornton
    August 19, 2006

    Abraham has a recurrence of Hodgkins Stage III-1-B, with relapse in less than a less than a year. “The cure rate for people who relapse ranges from 10 to 50%. Among those who relapse in the first 12 months after initial treatment cure rates are somewhat lower”

    http://www.merck.com/mmhe/sec14/ch177/ch177b.html

    The oncologist may be Dr. James Stark who is not associated with the Cherrix case, he believes the treatment program outlined by the state and its doctors is a “reasonable one”.

    http://www.wavy.com/Global/story.asp?S=4956264

    Still 25 percent is better than zero

  25. #25 Roger
    August 20, 2006

    Yes I do know Abraham. Dr. Stark said that he was an oncologist and he would recommend the same thing………high dose chemo, BUT Abraham only had a 25% chance of coming through high dose chemo. In other words there is a 75% chance he will die from it. Not good odds. Another oncologist that Abraham saw said that high dose chemo would kill Abraham. You really shouldn’t judge someone you don’t know. He is getting better. His cancer is NOT spreading and is under control. Shame on all of you for sending such negativity his way. He used to read your blog and he knows that no matter what anyone says to you all that you will not understand. He is a great person. Lots of people pray for you as do I. I think he is right. I will stop reading your blog also because even if you saw the proof as I have then you will explain it away. Good bye.

  26. #26 Roger
    August 20, 2006

    One more thing

    “Abraham has a recurrence of Hodgkins Stage III-1-B”

    Abraham is stage 2a and it is under control. It has never gone over 2a

  27. #27 Orac
    August 20, 2006

    “Abraham is stage 2a and it is under control. It has never gone over 2a”

    Actually, if Abraham’s tumor recurred after chemotherapy, almost by definition it is not “under control.”

  28. #28 anjou
    August 20, 2006

    Roger–
    Here’s a present for Abraham– hot off the press, a small study of kids with advanced refractory or recurrent hodgkins who gone thru transplant– oddly 75% didnt die… and most are alive 5 years later… calculate the percentages if you like!!

    Bone Marrow Transplant. 2006 Sep;38(5):345-9. Related Articles, Links

    Interferon-alpha after autologous stem cell transplantation in pediatric patients with advanced Hodgkin’s lymphoma.

    Petropoulos D, Worth LL, Mullen CA, Lockhart S, Choroszy M, Chan KW.

    1Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.

    Thirteen children with refractory or recurrent Hodgkin’s lymphoma (HL) received high-dose chemotherapy and autologous hematopoietic stem cell transplant (ASCT). After hematologic recovery, 10 patients were given interferon-alpha (IFN-alpha) as adjuvant therapy, starting at a dose of 0.5 x 10(6) U/m(2) subcutaneously, three times a week. The dose was escalated as tolerated. Patients were treated for a median of 12 (4-24) months. Transient myelosuppression was the most common toxicity and led to temporary treatment interruption in five patients. The IFN-alpha dose was increased in nine patients, to a median final dose of 3.5 x 10(6) U/m(2)/week. With a median follow-up of 67 (range 25-114) months, nine of the 10 patients are alive and in continuous remission. One patient relapsed. Three patients were not treated with IFN-alpha initially, two because of rapidly progressive disease. One patient received IFN-alpha for treatment of relapse after transplant, and is alive in remission 10 years later. IFN-alpha has activity in children with advanced HL, and prolonged, low-dose treatment given after ASCT can be tolerated. Its therapeutic effect as a post-transplant adjuvant warrants further investigation.Bone Marrow Transplantation (2006) 38, 345-349. doi:10.1038/sj.bmt.1705458.

    PMID: 16915224 [PubMed - in process]

  29. #29 Andrew Dodds
    August 21, 2006

    Roger –

    You seem t obe confused here. Assuming the numbers are correct, the chances are (with chemo) 75% that he would die FROM THE CANCER. Not from the chemo. You seem to be deliberately confusing the two.

    Without the treatment there is approxamately a 99.999% chance he will die from the cancer.

    And let me assure you, I and everyone else posting here wants Abraham to be in that 0.001 % of freak unexplained remissions. No one wants him to die. But cancer dosen’t respond to nice, fluffy, touchy feely feelings. It reponds, if at all, to (in altie terms) burning, poisioning and slashing, with all the collateral damage that this implies. That’s the reality that you have to deal with.

  30. #30 Crystal Montoya
    August 21, 2006

    Abraham is my hero. I am a 30 year old woman who has endured harsh chemotherapy for an immature teratoma and it caused a terminal bone marrow disease called myelodysplasia. I agree with Abraham’s decision to use more natural and nutritional approaches for his disease. I am using those methods for my MDS and doing very well with them. It doesn’t matter what any of you think, the only thing that matters is what Abraham feels is best for him. I do not feel you give him enough credit. Abraham is aware of what medical studies show and do not show regarding his disease and choice of treatment. Many people have healed from diseases, including terminal cancer and other terminal diseases using nutritional approaches. Argue as you may that this is not possible – it is possible – it’s happening all around you everyday. Acupuncture and chiropractors were considered quacks not too long ago but are now a part of main stream medicine and even covered by many insurance companies. More and more these ideas that many of you consider quackery will be embraced. Many nutritional approaches to disease prevention and treatment are already proven; they are just not advertised nearly as well as drug therapies are.
    As far as Abraham is concerned, none of this should be an issue in the first place. Abraham should have been left to his preferred treatment from the very beginning. He is old enough to make decisions regarding his body. The only thing this court battle did was cause Abraham stress that he does not need. Abraham’s choices are no one else’s business. All of you predicting his certain death should be ashamed of yourselves.

  31. #31 Hyperion
    August 21, 2006

    I don’t doubt that nutrition and exercise can help heal some things, they certainly helped me heal from a bruised sternum and concussion suffered in fights (of the sanctioned, martial arts variety). But cancer is a whole different issue.

    I think that it would certainly be more helpful to have more compassion for the pain that this young man has already been through and will go through in the future, but you must realize, Ms. Montoya, that most of the people who read and comment, and especially (I assume) the author of this blog, do want what is best for young Abraham, they want him to survive and they want him to receive the treatment that is most likely to ensure his survival. Friends of mine lost their 5 year old son to cancer (neuroblastoma, if I remember correctly) several years ago, and I arrived at the house shortly after he had passed away. I will never in my life forget the sound of his mother’s voice that day, and I am certain that many people have seen and heard far worse.

    Physicians make predictions on life and death all the time. There are even volumes written on end of life care, and I remember the first time I had to work on DNR policies (ok, not nearly as tough as dealing with actual living breathing patients, but c’mon, I was fresh out of college). I highly doubt that anyone is jumping up and down with glee at the prospect of anyone dying, least of all physicians or other healthcare workers. If anything, I suspect that people are merely expressing their frustration that this child is, for whatever reason, not receiving an adequate level of care, and especially that the decision to withold life-saving care may have been made based on false claims of the success of the Hoxsey treatment.

    Oh, and acupuncture and chiropractic are covered by insurance companies because CMS covers it, and CMS covers it because of political pressure.

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