The 16-year-old Virginia boy may undergo radiation and alternative treatments.
This story has been reported before by Orac and others, but I just wanted to add a couple of highly biased comments to the latest development in the case of a teenager who took chemotherapy for Hodgkin lymphoma, had awful side effects, then suffered a relapse and refused the advice of his medical oncologists, which was to undergo high-dose chemotherapy followed by a stem-cell transplant, which of course is one of the standards of care for relapsed Hodgkin lymphoma in a young patient.*
The family of a Virginia boy who has refused conventional medical treatment for cancer reached a settlement Wednesday with state officials, agreeing that he will see a new doctor while continuing his alternative therapy.
The compromise means that Starchild Abraham Cherrix, 16, will not have to undergo chemotherapy against his will, as a judge had ordered him to do.
I sympathize with Mr. Cherrix’s plight and understand perfectly why he would refuse going through a stem-cell transplant. His choice of alternative treatment, however, leaves something to be desired in my opinion:
The boy and his parents prefer the alternative – the Hoxsey method which uses herbal medicines, nutritional liquid supplements and a largely sugar-free, purely organic diet. The Hoxsey tonic, required in this method, is banned in the US but available in Mexico.
The Hoxsey treatment? For Hodgkin lymphoma? I’d be willing to put chemotherapy up against the Hoxsey tonic at any time and see which method produces the best outcome.
Say, what do I mean by outcome anyway? Well, if the outcome entitled long-term survival is what is desired by the patient, then conventional anti-cancer therapy in my opinion has the best chance to achieve this. If the patient is willing to accept the possibility that death from progression of Hodgkin lymphoma is more likely to occur with an alternative treatment, then I have no problem with the patient rejecting my therapy. One of the differences between conventional anti-cancer therapy and “alternative” therapy is that when I counsel patients about the risks, the side-effects, the possible benefits, the long-term effects and the possible outcomes of chemotherapy or targeted therapy, I know what the data are and I am not afraid to share it. For better or for worse, the treatment speaks for itself – I have nothing to hide, and no false hope to sell to the desperately ill. Don’t get me wrong – I try to sow optimism and hope in the barren field of despair, but as far as facing unpleasant realities, such as treating incurable cancer, or using chemotherapy that has horrible side effects, my motto is:
“Let the truth be your guide.”
I wish Mr. Cherrix nothing less than the total cure of his Hodgkin lymphoma. Just don’t make the mistake of blaming a bad outcome on sincere medical advice.
[For a description of some of the standard medical options for the treatment of relapsed Hodgkin lymphoma, please read the footnote below.]
*The selection of second-line chemotherapy regimens depend on the pattern of relapse and the agents previously used. Some studies suggest that late relapses (selected patients) can be successfully treated with the same regimen used for initial remission induction with favorable results if a second CR is achieved. Induction failures and early relapses will require chemotherapy regimens composed of agents not previously used before treatment with high-dose chemotherapy with stem-cell rescue. Some of the regimens previously evaluated are: Mini-BEAM, MINE, VIM-D, and EVA . Some studies have suggested that patients with minimal disease burden at relapse (not refractory) may not need additional treatment prior to high-dose chemotherapy with stem-cell rescue. However, patients tend to have an improved outcome when transplanted in a minimal disease state. Thus, cytoreduction with chemotherapy (see above) before high-dose chemotherapy with stem-cell rescue may be beneficial. In addition, salvage chemotherapy serves as a test for drug sensitivity and to facilitate the harvest of stem cells. Some studies suggest that nitrogen mustard, procarbazine, carmustine, and melphalan may adversely affect both quality and quantity of stem-cell collection.
Examples of salvage chemotherapy prior to transplant include ICE (ifosfamide, carboplatin, etoposide), DHAP (dexamethasone, cisplatin, high-dose cytarabine), ESHAP (etoposide, methylprednisolone, high-dose cytarabine and cisplatin).