Germany: A Mecca for Cancer Patients

I recently returned from a three-week tour of European cancer hospitals. My 3,000-mile journey took me and my staff to holistic clinics in Germany, Switzerland and Denmark. This tour reinforced my feeling, gained from three previous journeys, that these countries are world leaders in the integrative approach to cancer.

Because of their long historical traditions, and a more lenient regulatory environment, they have developed some approaches to cancer that are less toxic and more effective than what is generally available in America. Increasingly, Germany is a Mecca for cancer patients and an inspiration for holistic practitioners.

There is no single protocol embraced by all the clinics that I visit. In fact, they range from strictly naturopathic facilities to a few that perform clinical trials on immune-modulating drugs. But the majority practice integrative oncology, which means a combination of conventional methods (including small amounts of chemotherapy, when necessary) with innovative ways of killing cancer cells and supporting overall health.

Such measures include hyperthermia; mistletoe extracts; immune stimulants; fever therapy; ozone and oxygen treatments; homeopathic preparations, etc. They also emphasize art, dance and music therapy, as well as massages, baths and psychological support. Innovative diagnostic techniques include electroacupuncture according to Voll, thermography, and biological terrain assessment.

There is intense interest in electrical current treatments, or galvanotherapy, a technique that originated in Sweden, migrated to China, and now has found its way back to Europe. There is intense interest in dendritic cell vaccines. This hardly exhausts the list. German clinicians have the freedom to use new treatments outside the context of clinical trials, and do not suffer from the kind of harassment that is so common in the US and other countries.

At one German clinic, an American melanoma patient was given the drug DTIC in rather high doses. Normally, one would expect nausea and vomiting. But he also received whole-body hyperthermia. When he awoke from sedation, his first question was, "So, where are we going for dinner?" And in fact that very evening he and his wife went to eat in an Italian restaurant. To that point, he had experienced no side effects from his treatment.

At another clinic, a patient with profound lymphedema of the arm after surgery for sarcoma told of total relief after one session of hyperthermia. Yet hyperthermia is rarely used in America, and is still considered experimental and controversial.

Many innovative German clinics are located in spa towns, and they generally treat the person with cancer as an honored guest rather than a medical cipher. At some centers the apparatus is hidden from view in cabinets disguised as fine furniture. The food, of course, varies, but some is astonishingly good. A few clinics are like gracious four-star hotels.

Germany could well be called the home of alternative medicine. After all, homeopathy was formulated by Samuel Hahnemann (1755-1843), who came from Saxony. Naturopathy also originated in Germany, with the work of Father Sebastian Kneipp (1824-1897) and others. Kneipp emphasized diet, herbs, sunlight and water treatments. His emigré disciple, Benedict Lust (1872-1945) brought Kneipp's philosophy to America, renaming it Naturopathy. He opened the first U.S. health food store in 1896.

In Germany, signs of natural healing are everywhere. A conventional pharmacy usually features herbal and homeopathic treatments in the window. There are alternative doctors and clinics everywhere. Hundreds of alternative health books are published each year.

It is well known that the Germans are crazy for walking in the mountains and woods. There is a vast network of spas, which are founded on a naturopathic philosophy. Some of these baths (such as Baden-Baden) have been around since ancient times. Others date from the 19th or early 20th century. Their strange-tasting waters are filled with various minerals. Soaking in them is said to soothe the body and the soul. Thermal baths provide a primitive form of hyperthermia. There are also "Moorbads" (mud baths) of various esoteric kinds.

There are about 170 towns with the prefix "Bad" (meaning Bath) in their name, and this hardly exhausts the list. Each spa has its "Trinksaal" (drinking room) and its "Kurhaus" in the "Kurpark." Frequently, this Kurpark is the central focus of the town. Germans and other tourists stroll in the lovely park, soak in the pools, or take treatments at one of the many clinics that surround it. Facilities range from small hotels with saunas in their basements to elaborate medical centers and research facilities.

In America and England, there was once a large network of public baths as well, but that movement sank into obscurity. In Germany, spas are priced within reach of nearly all, and in fact many spas double as the town's swimming pool. You can still have a reasonably priced soak at the Lincoln Baths in Saratoga Springs, New York, but that is the rare exception. Nowadays, America's idea of a spa is an ultra-expensive resort where you pay megabucks for tiny portions of fat-free food. One week at a famous California facility will set you back $5,375.

For cancer patients, the proximity of holistic clinics to spas is an important feature. While patients are initially focused on their medical treatments, the level of comfort of the clinic helps to shape the totality of their experience. If patients and their companions are uncomfortable or bored, this impinges on the effectiveness of the treatment. In addition, the baths themselves and the pampering, may contribute to healing.

MEDIZINISCHE WOCHE

At the end of October, I had the honor of giving the concluding speech at the annual meeting of the German Society of Oncology. This was part of the 34th annual Medicine Week in Baden-Baden. "Medizinische Woche" is a huge event for alternative medicine: one indication is that the meeting program is now 316 pages in length. Participants come from as far away as Australia, New Zealand and Fiji to attend this famous meeting.

The German Society of Oncology (DGO) is composed of hundreds of cancer practitioners who integrate conventional cancer treatments with innovative supportive measures. The society was founded decades ago by Hans Nieper, MD and currently headed by Josef Beuth, MD, a researcher at the University of Cologne. My own speech was entitled "The Grand Illusion of Chemotherapy." (It is available online at www.ralphmoss.com/dgo2000.html.) It sparked considerable discussion among the attendees.

Later that week, I spoke to several hundred patients and physicians at the "Aiblinger Gespraeche 2000," another outstanding meeting conveened by Friedrich R. Douwes, MD and his St. Georg clinic. This was held in the spacious Kurhaus of the Bavarian town of Bad Aibling. My third and final lecture was at the Humlegaarden clinic in Humlebaek, Denmark, headed by Finn Scøtt Andersen, MD.

In all, I think that the treatments offered at these European clinics represents the best hope at the moment for cancer patients, including Americans. These clinics do not reject the useful parts of conventional oncology, but attempt to integrate modern knowledge into a more humane and rational treatment philosophy.

CHEMOTHERAPY AND LUNG CANCER

Adding chemotherapy to radiation therapy does not prolong survival in patients with operable, non-small-cell lung cancer, according to a large, randomized study published in the October 26 issue of the New England Journal of Medicine.

Two hundred and forty-two patients were randomized to receive radiation therapy alone while 246 received radiation therapy plus chemotherapy. The median survival time was 39 months in the group given radiotherapy and just 38 months in the group that received chemotherapy and radiotherapy. In other words, adding chemotherapy made the results a little worse.

The authors, from the Eastern Cooperative Oncology Group, concluded that "compared with radiotherapy alone, adjuvant radiotherapy and chemotherapy with cisplatin and etoposide does not … prolong survival in patients with completely resected stage II or IIIa non-small-cell lung cancer {N Engl J Med 2000;343:1217-22}.

In an accompanying editorial, two oncologists, Desmond N. Carney, MD and Heine Hansen, MD, concluded that adjuvant chemotherapy in such patients "should not be considered standard care."

What isn't mentioned is that postoperative radiotherapy by itself may be useless or harmful to non-small cell lung cancer patients. A study published in the Lancet in 1998 analyzed results in 2,128 patients who received surgery alone or surgery plus adjuvant radiation therapy.

This analysis revealed a 21 percent increase in the risk of death in patients receiving radiation therapy. Harm was greatest for patients who had early (stage I/II) lung cancer. The Lancet authors concluded, "Postoperative radiotherapy is detrimental to patients with early-stage completely resected NSCLC and should not be used routinely for such patients" {Lancet 1998;352:257-63}.

I was told by some radiologists that they intended to continue giving radiation therapy to such patients, despite the Lancet report. I wonder if medical oncologists will also continue to give adjuvant chemotherapy to such patients, despite the New England Journal article? Isn't it time to take a more serious look at non-toxic treatments?

THE VANUATU CURE

One of my clients asked me to look into a new website, www.cancer.vu. It was offering a remedy for cancer, she said, which appealed to her.

What I found was scary: some nameless person or persons, whose web business was based on a small island in the Pacific, was offering a secret cancer "cure" for an outrageous price.

A scientist [they say] has discovered that the sap of a common plant has 'magic bullet' effectiveness against a wide range of cancers. But this unnamed scientist has greedy investors who are trying to monopolize this cure for their own profit. Happily, these humanitarians operating out of the island republic of Vanuatu obtained a copy of the patent application, and have made it available to the general public.

The treatment comes as both an external salve and an injectable medication. They won't say what it consists of or how it was made. It has not been approved by any regulatory body. In fact, it is sold as a veterinary product. You must assume all risks when you purchase it.

If something untoward happens (or if nothing happens) don't try to find them in Vanuatu. That's just a dropbox. They give no names, email or street addresses, or phone numbers. They announce in advance that they won't correspond in anyway with anyone for any purpose.

They do claim that the product is "100 percent successful" for malignant melanoma, as well as brain metastases and breast, lung, colon, cervical, squamous and basal cell cancers. Oh yes, and prostate cancer, too. They give a little sample of the patent application: if you believe it is authentic, then the product was only tested in a single cancer cell line.

Ironically, the company selling this product (which, for all we know, could be distilled water) calls itself Bioethicals, Inc. Don't you just love it? They are ethical because they are making this "cure" available at "minimal cost to all cancer sufferers in the world." The minimal charge is $2500 for 10 vials. If you took it for just three months, it would set you back $22,500. By a lucky coincidence, Vanuatu also happens to be a center for numbered bank account.

I hate to attack any new cancer treatment. But if proponents of new methods are honest, they need to stand up and be counted. Paranoid fear of the FDA is no excuse. They need to make a good faith effort to have their treatments carefully evaluated by independent outsiders, including the National Center for Complementary and Alternative Medicine. A willingness to engage in cooperative research is, for me, the hallmark of seriousness in the field of cancer. Until then…Internet shopper beware!

IMMUNE SURVEILLANCE CONFIRMED

Finally, an exciting article in the Lancet shows that people who are immunodeficient really do have an increased RISK of cancer. This so-called immune surveillance theory was viciously attacked by the "quackbusters" a decade ago, because it gave aid and comfort to non-toxic approaches to cancer.

Scientists at the Saitama Cancer Center in Japan have now shown that people whose white blood have medium to high cytotoxic activity of their peripheral-blood lymphocytes have far less cancer than those whose cells have low cytotoxic activity, in fact up to 50 percent less. Higher rates of cytotoxic activity is associated with normal body weight, not smoking, an increased intake of green vegetables, and moderate alcohol consumption {Lancet 2000;356:1795-1799}. All good advice, in any case.