It only has to be done once

This weeks blog is written in two parts. The first part is my weekly blog and the second is an article that I wrote and was published in Australian Doctor this week that is referred to in the blog.

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Part A

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There has been some discussion recently in the medical press regarding my case history; its accuracy and its relevance to others with cancer. It seemed to me that the matters raised had been satisfactorily answered but then Linda Calabresi, medical editor for Australian Doctor (the journal that goes weekly to all Australian GPs) suggested the record needed to be set straight, so my response has been published in AusDoc and is reproduced below.

The issues of contention revolved around the timelines for my illness and the dates on photos taken of my cancer, as reported my Dr Ainslie Meares way back in 1978, and the 30 year follow-up of my case in 2008; as well as me being described as having followed a vegan diet during my recovery.

The reality is that I was diagnosed with osteogenic sarcoma in January 1975, had metastases confirmed in December 1975 and was found to be cancer free in June 1978. What happened in between was quite complex. I tried most things you could think of and probably a few you would not!

When I recovered Ainslie Meares, who had introduced me to meditation, reported my case in the Medical Journal of Australia. While he acknowledged many of the things I had done, he felt the most significant factor may well have been intense meditation.

It is true he reported I had more severe disease when we first met than I did, however, he had not shown me his article before submitting it and this error seemed to me to be of no material significance. If a woman has a pregnancy confirmed, but the dates are wrong; unless there is major intervention, she will still have a baby. I certainly had a very poor prognosis when I went to Dr Meares; if there had been no major intervention, all the experts were sure I would have died within a few months. As it was, I did recover and I too felt the meditation was crucial.

The main photo in contention was of the rather large mass of cancer on my chest that was enlarged many years ago and then mis-labelled as being taken in July 1977. In fact it was taken before I began chemotherapy in October 1976. This again seemed of minor importance but I do have the complete series of photos taken once each month from then until the chest had cleared completely towards the end of 1977.

Because my history is so complex, when it came to having it told in book form, I decided not to do it myself as an autobiography, but to agree to a journalist, Guy Allenby writing it. Guy had full access to my medical records, the meticulous diaries I kept, and he interviewed my medical staff, family, friends and colleagues. In my opinion, the timelines in The Dragon’s Blessing are accurate, so anyone interested will find them there.

Regarding what I ate during my recovery, it was mostly vegan. If you eat meat once a week, you are not strictly a vegetarian but you certainly are not a rabid carnivore. It is hard to characterise diets in a few words, and anyway, I do not recommend people do exactly what I did. What I do recommend has been readily available since “You Can Conquer Cancer” first came out in 1984. Anyone really interested could come to the residential or non-residential programs I established, come to a workshop or listen to my CDs on food. I have also written some blogs on food and will do more soon, particularly on why it makes good sense to avoid dairy and adopt a relatively low protein diet.

The good thing about all this discussion is that it has provided another opportunity to present the merits of a therapeutic lifestyle for people with cancer in a medical forum.

Cancer is a lifestyle disease and the value of a therapeutic lifestyle needs to be discussed early for people diagnosed with cancer just as it is for people when they are first diagnosed with heart disease or diabetes.

If we really want to treat cancer best, we need to prevent it and the soundest way to prevent it is through a healthy lifestyle.

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Part B - Taken from Australian Doctor 17th Nov, 2010

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The case for lifestyle

Well-known cancer survivor Dr Ian Gawler presents his side of the story.

One of the good things about being described as a high profile alternative treatment story is that you are alive to engage in the discussion.

In referring to my recovery from metastatic osteogenic sarcoma and my work over 30 years with lifestyle-based self-help programs, Linda Calabresi’s editorial [i] “Providing hope comes with a duty of truth” (27 October) suggests “the record be set straight”.

First then, the term “alternative”, as used in some reports of the case, is misleading. Cancer management falls into three broad categories: conventional medicine, complementary and alternative medicine, and lifestyle medicine. My personal recovery involved all three, while my work focuses on lifestyle.

The facts of my case were thoroughly documented in 2008 by Guy Allenby [ii] in “The Dragon’s Blessing”. So while back in 1978 (psychiatrist) Dr Ainslie Meares [iii] reported that I had more severe disease when I first saw him than I actually did, and these timeline errors were carried over into the 2008 follow-up [iv], this has little material relevance to the important facts. On meeting Dr Meares, I did have metastatic disease. I did have a prognosis of 3 to 6 months. I am alive more than 30 years later.

My personal story has direct relevance to people with osteogenic sarcoma. It changes the landscape of that disease. The fact is at least one person has survived metastatic disease for over 30 years. It only has to be done once to show that it is possible, so my story offers real hope.

However, it is my work that has the most relevance to the wider body of people affected by cancer. The lifestyle I teach now goes well beyond what I did 35 years ago. Research and experience leads to ongoing development. While my story may inspire, I have never recommended others do exactly as I did. This was clearly documented in my book “You Can Conquer Cancer”[v],first published in 1984.

The evidence for lifestyle factors enhancing quality of life and cancer outcomes is growing steadily. Compelling examples are Dean Ornish et al’s [vi] randomised lifestyle intervention for prostate cancer and the evidence suggesting regular exercise halves the risk of dying for women with primary breast cancer [vii]

And consider that spontaneous remissions - improvement or recovery without clear medical cause [viii] - are thought to occur once in every 60,000 to 100,000 people [ix]

During a period when 8,400 cancer patients attended Gawler Foundation’s lifestyle programs, 43 people who fit the description of “spontaneous remissions”[x][xi] have been recorded. This equates to one in 195, which is 300 times more than the average.

While this data may be crude, it points to why the public is so interested in lifestyle programs, and surely warrants more research.

Lowenthal [xii] says “the speciality of psycho-oncology and the more recent development of 'integrative oncology' arose to some extent out of the work of Gawler and his followers.”

The next step is lifestyle medicine needs to have the same prominence for cancer as it does for heart disease and diabetes.

Dr Gawler OAM, BVSc, MCounsHS is retired founder of the Gawler Foundation.

References:

1. Calabresi L. Providing hope comes with a duty of truth. Aust Doct 2010: Oct 27:
2. Allenby G. Ian Gawler - The dragon’s blessing. Melbourne: Allen & Unwin, 2008.
3. Meares A. Regression of osteogenic sarcoma metastases associated with intensive meditation. Med J Aust 1978; 2:43.
4. Jelinek GA, Gawler RH. Thirty-year follow-up at pneumonectomy of a 58-year-old survivor of disseminated osteosarcoma. Med J Aust 2008; 189: 663-665.
5. Gawler IJ. You can conquer cancer. Melbourne: Hill of Content, 1984. Revised edition: Melbourne: Michelle Anderson 2001.
6. Ornish D, et al. Intensive lifestyle changes may affect the progression of prostate cancer. J Urol 2005; 174:1065-70
7. Irwin ML, et al. Influence of pre- and post-diagnosis physical activity on mortality in breast cancer survivors: the health, eating, activity and lifestyle study. J Clin Oncol 2008: 26(24): 3958-64.
8. Bakal. DA Minding the body: clinical uses of somatic awareness. New York: Guilford 2001.
9. Jerry LM, Challis EB. Oncology. In Rakel ED (Ed) Textbook of Family Practice, (3^rd ed., 1061-1081). Philadelphia: Saunders 1984.
10. Gawler IJ ( Ed). Inspiring people – stories of remarkable  recovery and hope from the Gawler Foundation. Melbourne: The Gawler Foundation, 1995.
11. Kraus P. Surviving cancer – inspiring stories of hope and healing. Melbourne: Michelle Anderson Publishing 2008
12. Lowenthal RM. Snake oil, coffee enemas and other famous nostrums for cancer – a recent history of cancer quackery in Australia. Cancer Forum 2005; 29: Issue 3.