STATS ARTICLES 2006

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A Tale of One Teen and Two Cancer Treatments –
Just Don’t Say One of Them Doesn’t Work

July 26, 2006
Trevor Butterworth
Coverage of the Abraham Starchild Cherrix’s battle to forgo chemotherapy for alternative cancer therapy avoids talking about the fundamental issue: does the Hoxsey method work? And how would one go about making that judgment?

Here’s an ethical dilemma: How do you report a treatment for cancer that has no basis in science, no demonstrable causal effectiveness, isn’t available in the United States because it is banned by the Food and Drug Administration, and did nothing to cure the person who invented it?

Do you call the Hoxsey treatment quackery? Snake oil? A danger to public health? No, because journalists aren’t supposed to decide what is and isn’t proper medicine.

Unfortunately this respect for the fact that many Americans “believe” conventional medicine is less science than a matter of belief has taken a troubling turn in the case of a teen who want to take herbs rather than have chemotherapy for Hodgkin's Lymphoma. News reports on the decision by a judge to allow Abraham Starchild Cherrix to forego chemotherapy simply avoided any discussion of why the alternative treatment is banned in the United States and considered quackery by the medical profession.

The Associated Press story, which was carried by dozens of news organizations, simply reported that Cherrix

“had refused a second round of chemotherapy when he learned early this year that the cancer had returned. Abraham chose to instead go on a sugar-free, organic diet and take herbal supplements under the supervision of a clinic in Mexico.

And that was it on the underlying medical issue. Earlier Associated Press accounts did no better. After leading its story with the debilitating effects of chemotherapy on Cherrix’s body, The Washington Post reported that “Abraham began researching an alternative treatment that consists of herbal supplements and an organic diet free of processed sugar. The treatment was initiated by Harry Hoxsey, a former Texas cancer clinic operator who was accused by the Food and Drug Administration of peddling worthless medicine -- and who died of cancer.

But Abraham's father became a believer in the Hoxsey method when the family traveled in March to the clinic in Mexico. "I've talked to the people who survived, and not only did they survive, they didn't have any side effects," he said.

With his family's support, Abraham began the Hoxsey regimen several months ago. His father says Abraham's tumors continue to grow, but more slowly.”

This may be a sympathetic approach to take with a suffering teenager and his family. But it is a little too sympathetic. By describing Hoxsey as a “cancer clinic operator,” readers might just think that Hoxsey had medical training; he didn’t. It’s also misleading to say that Hoxsey was “accused” of “peddling worthless medicine” when the FDA actually forced him to close all of his treatment centers for peddling worthless medicine.

(By comparison, ABC7, Washington DC’s local ABC news affiliate, did a far better job of covering the medical background to this story.)

Another problem with the Washington Post’s coverage is that its earlier stories link to Abraham’s Journey, a site that covers the case from his perspective and solicits donations for the Cherrix family, but there are no links to any conventional medical source on treatment for Hodgkin's Lymphoma or, crucially, the American Cancer Society’s examination and dismissal of the evidence for the Hoxsey method.

The issue of what counts as reliable evidence came up in Ann Curry's interview with Cherrix on the Today show:

CURRY: The American Cancer Society says there is no evidence that this treatment that you're taking works. So why do you have faith in it?

Mr. A. CHERRIX: Well, the American Cancer Society says that there's no evidence, but there is plenty of evidence if they would take the time to actually look through it. I've done extensive research, and I've read the testimonies of people who have been cured by alternative medicine, and I've seen it firsthand. I've met with these people.

This is the kind of argument that presumably led syndicated columnist Cal Thomas to write “ I have heard Starchild Cherrix interviewed… and he sounds intelligent, articulate, reasonable and capable of making such a major decision [about his treatment].”

But here’s the problem: Cherrix’s choice to abandon chemotherapy may have the appearance of rationality – he engaged in pro and contra reasoning. And that rational exercise in relation to medical treatment is usually considered an individual right when you are an adult.

But one cannot be impartial with respect to the evidence. For Cherrix to weigh the benefits of Hoxsey over chemotherapy may seem like a rational exercise; but it is fundamentally irrational if there is no attempt to apply a common standard of evaluation to both therapies.

Not to be cruel, but few, if any, 16-year olds can claim genuine expertise in oncology or epidemiology or the statistical methods needed to evaluate clinical research. Indeed, given the formidable training required to conduct such research, it is arguable that no 16-year old could possess such expertise (for similar reasons, we do not consider even those teenagers who possess remarkable intellectual talents as candidates for supreme court vacancies, chairs of constitutional history or even TV pundits).

And then there is the dearth of comparable, analyzable evidence for the alternative cancer treatments. As the American Cancer Society notes on its website:

“Only 2 human studies of the Hoxsey herbal treatment have been published. One was published in a pamphlet provided by the Tijuana clinic and simply contains a description of 9 patients who received the treatment. It concluded that the treatment is effective, even though most of the Hoxsey-treated patients received standard cancer treatment in addition to the Hoxsey treatment. The other study published in the Journal of Naturopathic Medicine involved 39 people with various types of cancer who took the Hoxsey herbal treatment. Ten patients died after an average of 15 months and 23 never completed the study. Only 6 patients were disease-free after 48 months.

The National Advisory Cancer Council studied many of Hoxsey’s patient records and learned that most of the patients had never had biopsies, so that there was no confirmation that they actually had cancer. The National Cancer Institute investigated 400 patients who were reported as cured by Hoxsey. Patients or their families were interviewed, and all records were carefully reviewed. These patients fell into 3 groups: those who had been treated, but didn’t actually have cancer; those who had received successful conventional cancer treatment before seeing Hoxsey; and those who had cancer and had died of it, or were still alive with evidence of cancer. Out of the 400 cases, not one case of a Hoxsey cure could be documented.”

The fact is that the way the media covers this case will have an effect on public health and the public's understanding of science. Reporters must go beyond the mere right to choose treatment in their stories and focus on what counts as a rational choice in choosing between treatments.

The principles enunciated by Cherrix are, at best, those of 19 th century medicine. Adults have the right to choose such principles in guiding their treatment if they so wish; but they need to be aware that you can’t practice 19 th century medicine without achieving 19 th century mortality rates.

The entire “conventional” medicine community doesn’t believe that Hoxsey is a hoax without reasons that speak to the success of science and the failure of non-scientific thinking. Those reasons need to be explained by reporters. “He said, she said” journalism is not just insufficient in a case like this, it’s wrong. All the hearsay in the world cannot “balance” out one rigorously-executed clinical trial. To act otherwise is to endanger the public.