Respectful Insolence

I’ve written extensively before about Starchild Abraham Cherrix, the (now) 17-year-old who was diagnosed with Hodgkin’s disease when he was 15 and who, after one course of chemotherapy, refused any further evidence-based medicine in favor of the quackery known as Hoxsey therapy. His refusal led to a big legal battle in Virginia, and the court ultimately (sort of) compromised, letting Abraham go to Mississippi to be treated by a radiation oncologist with taste for alternative medicine named Dr. R. Arnold Smith, who would give him low dose radiation and an unconventional variety of immunotherapy whose efficacy is not supported by evidence, as well as allowing him to undergo Hoxsey therapy. Not too surprisingly, Abraham relapsed in January. He had to undergo more radiation therapy in January to enlarged lymph nodes under his arms.

Again, not too surprisingly, he’s now relapsed again:

Seventeen-year-old Abraham Cherrix will head back to Mississippi this weekend for a third round of radiation therapy for his Hodgkin’s disease.

His most recent scan showed a small dark spot on his right lung, for which he will receive pinpoint radiation treatment.

Abraham and his family fought the court system on the Eastern Shore last year to pursue nontraditional cancer treatment. After seeking an alternative treatment in Mexico for his lymphatic cancer in spring 2006, his parents were charged with medical neglect. Abraham was ordered by a juvenile judge to return to chemotherapy last July, a decision that made news across the globe.

In August, that decision was reversed by a court-ordered compromise in which Abraham agreed to a blend of conventional and innovative treatment.

“Innovative” treatment? The immunotherapy that Dr. Smith is administering, which he calls “belly plaques,” is not “innovative.” It isn’t even supported by decent clinical evidence. Ironically, it looks pretty painful, and ostensibly the reason that Abraham refused further chemotherapy is because he didn’t want the side effects. Sadly, once again,Abraham and his mother exhibit magical thinking in their assessment of the situation:

Abraham and his mother said they were disappointed by the most recent tumor the scan showed but pleased that the cancer did not appear anywhere else.

“I look at the bright side: There’s no other cancer, just a little spot; let’s go in and kill it,” he said in a telephone interview from his new home in the western Virginia town of Floyd.

[…]

Abraham’s first radiation treatment at the Mississippi center was last fall and focused on two tumors, one in his neck and one near his windpipe.

In December, a scan showed five new tumors, one each in the lymph nodes under his arms, one near his collarbone and two in his lower left lung. He returned to Mississippi in January for radiation.

“The cancer’s not on the level that it was before, so what we are doing is working,” Rose Cherrix said.

His cancer’s recurred three times now, and he and his mother think that what they are doing is correct? Treating this local tumor is very unlikely to cure Abraham’s cancer. Chances are, the cancer will pop up somewhere else in his body. Dr. Smith and Abraham can play a game of Whac-A-Mole with his cancer for quite a while, but he needs systemic therapy to kill the microscopic deposits of tumor that are responsible for new tumors popping up. He may even need high dose chemotherapy with a bone marrow transplant. Without chemotherapy, sooner or later Abraham’s very likely to develop massive disease, with tumors either too numerous or too large to radiate.

I hope it’s a long time before that happens. Meanwhile, every passing week in which Abraham insists on alternative medicine undergoing what is in essence effective local therapy for individual tumor deposits but ineffective systemic therapy for his cancer lowers his chances of ever making it to be old enough to drink legally

Comments

  1. #1 MarkH
    June 21, 2007

    Pretty sad. This kid’s going to show up one day as one big tumor if they keep dicking around with treatment.

  2. #2 catofmanyfaces
    June 21, 2007

    Wait, wasn’t that the plot of some old 50’s sci fi film? Some army guy grows into a giant and goes on a rampage because his entire body is one big tumor?

    Too bad the kid seems to already have lost it.

  3. #3 AnnR
    June 21, 2007

    If they’d gone through with the original plan the kid would most likely be fine right now and spending the summer doing something besides getting radiation that isn’t going to fix him.

    Why a family would get themselves into this is so irrational I can’t even begin to understand it.

  4. #4 Dorothy
    June 22, 2007

    I know Abraham personally. He used to live about fifteen minutes from me until he moved to Floyd. I hadn’t seen the family for awhile until Jay stopped into a business I worked and told me that the family had fallen apart. I had no idea about the foreclosure until I read it here tonight and I am really upset that everything had to lead to this. I knew the Cherrix family for years. The whole family would come into a local restaurant where I work and the kids loved me to death. Abraham was always full of smiles and to think he’s going through this, it really hurts to hear. I do believe in holistic healing but maybe it’s just not enough this time. I believe in their philosophies, but I don’t want Abraham to die, either. It’s a sad situation.

  5. #5 Randi
    June 22, 2007

    I find your article very insulting. As a parent we should have the right to do what we feel is best for our children. The government should not be able to step in simply because you want to try an alternative treatment. It would be different if they did nothing about it and allowed him to die slowly. They are taking the measures they feel are necessary. No one can say what he would be doing had he undergone the government mandated treatment. Cancer in any form is not an exact Science, it does not work in black and white. When a Doctor tells you that you have a certain chance of survival that is an estimate, not a guarantee. There are some people who die from the treatment itself and NOT the disease.

    Remember this is still a child. Show him some respect and instead of putting your hatred and annimosity out there, how about you take that energy and send a prayer instead.

  6. #6 Andrew Dodds
    June 22, 2007

    Randi –

    No, there are limits on ‘parent’s rights’ aimed at stopping senseless death and injury. What Abraham’s parents are doing IS allowing him to die slowly.

    Had he undergone best practice treatment then, yes, he might still have relapsed. But at least he would have had a fighting chance, unlike with this’alternative’, which gives him essentially no chance. And at least standard medicine is *honest* enough to say that it’s treatments might not work. ‘Alterative’ practictioners don’t even mention the possibility.

  7. #7 dj
    June 22, 2007

    To Randi:

    The options for this child are:
    1) An unproven, undocumented therapy with no guarantee of success.
    2) A standard of care that has a high cure rate documented in multiple studies and years of medical experience.

    By your logic, the parent should be able to do whatever they wish to this child and the government should not be able to do anything about it.

    So I pose to you the following, under your logic:

    Let’s say a certain sect/group/population believes that smearing horse excrement on their children’s bodies will cure them of pneumonia,strep throat,menningitis, or appendicitis.

    By your logic, the parents should be allowed to treat their children in this manner.

    I believe in freedom and hate governmental intrusion, BUT children have to be defended against the idiocy of their parents.

    The fact that one procreates does not mean they can make rational decisions for their children in all instances.

  8. #8 Calli Arcale
    June 22, 2007

    Randi,

    There are parents who think it is appropriate to commit infanticide — a cheaper alternative to abortion. Others feel that enforced servitude is appropriate. Some believe in euthanasia, and believe they can make the executive decision as to when the time is right for their children. Some have strange ideas about nutrition, such as the parents of the baby who recently died of malnutrition because they had him on a bizarre vegan diet not suitable for an infant. The irony of that one is that two mainstream options were available: soy-based formula, and human breastmilk. Yet they chose neither. They did not want their child to starve to death, and they were definitely not doing nothing.

    By your logic, Randi, they should be vindicated in court, because only parents should have the right to do what they feel is best for their children. (They are facing negligent homicide charges.)

    No. There MUST be limits. These children did not chose to have parents like this. Insulting? Perhaps. But the alternative is to allow children to suffer and die needlessly.

    I have respect for the child, and even his parents. I have prayed for all of them, as I feel is appropriate, being that I am a Christian. They certainly need peace in their hearts, as this cannot be fun for them. But I have no respect whatsoever for their decision.

  9. #9 A T Savage
    June 22, 2007

    I have met this family as well, they performed as they believed and I applaud them… Keep in mind that traditional medicine was used…. Did it work… you answer that question… I was also in court when Jay stated that he aided Abraham on going off the VITAMINS that the doctor prescribed in Mississippi … even though it was a treatment he had agreed to in court…. Do not call the avenue they tried a Quackery…. Most chemo doctors would rather die then receive the treatment they administer…. Everyone makes choices… and we have to live or die with or for them… i am a soldier, i know… Abraham is a very intelligent and mature young man… I have been very impressed by him… he is ready to face and accept his decisions, and i feel that they are ones that have improved his life to this point.

  10. #10 Orac
    June 22, 2007

    Do not call the avenue they tried a Quackery

    Hoxsey therapy, which is what Abraham chose before his agreement to undergo radiation plus an ineffective immunotherapy, is quackery. Period. Your telling me not to call it such does not change that simple fact.

    The radiation therapy Abraham is choosing now is not quackery but it is inadequate to the task of curing him. He needs high dose chemotherapy and stem cell rescue if he is to have a reasonable shot at long term survival.

    Abraham may think he’s ready to accept his decisions, but is he ready to accept death as the consequence of them?

  11. #11 anonimouse
    June 23, 2007

    There are two different issues at play here:

    1. If Cherrix wants to gamble with his life using unproven therapies and he’s found competent to make that choice, then he gets to. If Cherrix was 18 instead of 16, we wouldn’t even be having this discussion.

    2. The “therapies” Cherrix are using are junk with virtually no chance of success.

    Trying to intertwine the two is where we get into trouble.

  12. #12 Skeptyk
    June 23, 2007

    I agree that Abraham is an intelligent young man, and that contributes to the tragedy of the failure of informed consent in this case. From all I have read over many months about this case, the Cherrix family was misinformed, underinformed, disinformed by much of the altmed world.

    Once again, misty mysticism and charismatic paternalism lend glamour to quackery and we lose another child to foot-dragging false hope.

    I think the fallacy of moderation, a predictable result of “integrative” pandering, will see lots more of these cases. It will be: “Let’s try a little surgery and some Hoxsey, (not the surgery and radiation my oncologist wants)” or “Let’s try the IV vitamins; if it doesn’t work, we will consider the chemo”.

    As if cancers are some beings who will respect your earnest, mindful efforts. As if any therapy will work if you believe hard enough.

  13. #13 Orac
    June 23, 2007

    Exactly.

    The problem with taking the “let’s try this and if it doesn’t work we’ll take the chemo” approach is that, by the time you realize that the woo isn’t working, it may be too late. At the very least your chances of cure will have been markedly decreased by the delay. With cancer, the first shot taken at it is the best shot. You have to go after it with the most effective therapy on the first try, because if you go after it with less than optimal therapy the first time you’ve burned a bridge. When the tumor comes back, the chance of curing it drops dramatically.

  14. #14 Skeptyk
    June 23, 2007

    A T Savage writes: “Most chemo doctors would rather die then receive the treatment they administer….”

    Liar.

    And a very evil nasty lie at that. First, cite some data for this crap. Then, consider your idea. You are saying that medical oncologists are cruel monsters. If someone is willing to subject other people to something so awful that they themselves would rather die than use it, then they are Mengele. Do you really believe this? Do you really think that cancer specialists, who see real human suffering, and choose to work to eliminate cancer, are actually either suppressing “the real cure” for some undefined wealth and/or gleefully administering nasty drugs that are worse than death for some undefined wealth or just sadistic kicks?

    Have you actually made this argument to an oncologist? To her face?

    And do you really think that dying of cancer is easier than chemotherapy? You live a sheltered life, do you?

    BTW, much cancer therapy is a lot more tolerable than the horror stories and TV movies make it out. Sometimes cancer patients feel bad that they don’t feel worse, the paradox of your friends and family thinking you should be bad and puking 24/7 and you want to be sick enough to justify their kind concern.

  15. #15 Skeptyk
    June 23, 2007

    I meant “bald and puking” in that last sentence…

    The extent of magical and just nonsensical thinking was exemplified months ago when Abraham said (AP story last July): “So there’s that possibility that somewhere along this line we made a wrong decision. But you know what? If I die, I’ll die happy, and I will die healthy, and I will die in my home with my family, not in a hospital bed, bedridden and sick.”

    Um. No one dies healthy from cancer.

  16. #16 Skeptyk
    June 23, 2007

    I meant “bald and puking” in that last sentence…

    The extent of magical and just nonsensical thinking was exemplified months ago when Abraham said (AP story last July): “So there’s that possibility that somewhere along this line we made a wrong decision. But you know what? If I die, I’ll die happy, and I will die healthy, and I will die in my home with my family, not in a hospital bed, bedridden and sick.”

    Hmm. No one dies healthy from cancer.

  17. #17 Save Your
    July 2, 2007

    I wish he would try intravenous sodium ascorbate 75 to 150 grams per day (infused slowly) about five days a week, potentiated by alpha lipoic acid or vitamin K3 and combined with high dose oral administration of ascorbate (with frequent dosing to maximize blood plasma concentration) and numerous other supplements with immune-stimulating and/or anti-cancer properties. There are other viable non-toxic or minimally toxic options with curative potential that could obviate the need for conventional chemotherapy as well.

    No magic bullets, but then chemo isn’t either, is it? First go ’round of chemo wasn’t exactly magic for him, that’s for sure. Might make sense to try a different approach before reverting to what didn’t work before. Should be easy to understand his reluctance to revisit that which didn’t work, somehow expecting a different result.

    It’s a high stakes game, and nothing is certain, but ultimately he’s the guy who has to live–or not–with the results. Let him decide what seems worth the risk. Why must his decision be the same as yours, especially in light of his having given that approach a try already? He’s not doing what I would do in his shoes, either, but I don’t condemn him or his parents for that.

    Always amazes me that when natural, more gentle approaches fail it’s taken as validation of the “quackery” label, but when they work, it is attributed to coincidence or “spontaneous remission.” There are definitely some useful therapies validated by repeated clinical successes that have been suppressed. It’s time for the scientists to step forward and do some legitimate research on some of them so that they may be more widely applied and to reduce the numbers of people needlessly dying.

  18. #18 Natalie
    November 26, 2007

    I don’t usually post on blogs five months after the discussion has basically ended, but you, Save Your, are such an idiot I feel like I have to comment. You write: “No magic bullets, but then chemo isn’t either, is it? First go ’round of chemo wasn’t exactly magic for him, that’s for sure. Might make sense to try a different approach before reverting to what didn’t work before.”

    No competent doctor or cancer researcher claims that chemo is a magic bullet. That’s exactly why this boy’s doctors suggested a second round of chemo – they know that chemo usually needs to be repeated. He didn’t finish the original treatment, so it’s hardly surprising that it didn’t work. He then tried an alternative treatment five different times and still has cancer. So when the chemo fails once, when it hasn’t actually been completed, you say “move on to something else”. But when his BS alternative treatment fails on numerous occasions, you suggest he stick with it.

    You also write: “There are definitely some useful therapies validated by repeated clinical successes that have been suppressed.”
    What useful therapies? What studies have demonstrated any statistically significant amount of effectiveness? Have any studies suggested any logical method of effectiveness? Who is doing this suppressing?

    The only people who are needlessly dying are these poor people who are scammed by unscrupulous altmed practicioners or fool themselves into believing that this nonsense will help anymore than simply doing nothing.

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