In the winter 2000 issue, we printed a case report of an unusual clinical course of a brain tumor in a 3-month-old girl who had several operations and who also had ministrations from a Russian faith healer who was featured on a TV magazine show. We asked our readers to present a rational or more mundane and scientific explanation than intercession by a faith healer.
Dr Sandweiss’s was the only entry in the race, and yet he found the one clue that led to the more prosaic reason: the fact that the tumor had shown signs of regression and necrosis before the faith healing began. Other reasons he presents are more speculative, may not be necessary, and may even weaken his case.
Cancer cells die and tumors necrose for a variety of reasons. So-called spontaneous remissions, better called “unexplained regressions,” are examples of a natural, final common pathway in the natural history of some treated and untreated cancers. —Eds.
I am writing in regard to the case report in the Scientific Review of Alternative Medicine attributing an apparent cure of glioblastoma multiforme to psychic healing.1 The medical history of this child is consistent with anomalous improvement. Anomalous improvement refers to the clinical course of treated or untreated disease that is significantly more favorable than historical patterns. Anomalous improvement of rapidly fatal malignant disease covers a spectrum of disease progression that includes: slowed progression, stability, regression with persistence, remission with recurrence, and remission with apparent cure. The patient under discussion falls into the last category.
Hirshberg et al. have described cases of “remarkable recovery” from malignant disease that coincided with serious infections and/or fever.2 Coley noted that the administration of bacterial toxins had a favorable influence on the course of some patients with sarcoma.3 It has been suggested that patients with lung cancer who develop an empyema after pneumonectomy have improved survival.4 Perhaps certain infectious processes or highfever might favorably influence tumor progression. Is the patient under discussion an example?
In October 1994 the patient “developed a severe illness of high fever and lethargy.” Subsequently, in February 1995, the neurosurgeon expressed surprise that the tumor had not progressed more rapidly during the previous 4 or 5 months. Three months later “whitishcreamy material, containing many WBCs but no bacteria” was aspirated from the right frontal area. In June 1995 (1 month later) she was found to have “a fibrotic mass adherent to tumor” and “a thick fibrotic wall around the tumor islands.” Was this intense inflammatory reaction in response to an infectious process or to the tumor itself? It certainly seems to have had a favorable influence in containing the tumor.
It is possible that psychosocial factors favorably influence progression of malignant disease. Hirshberg describes spontaneous cures of cancer that have been anecdotally associated with highly supportive caregivers, positive outlook, and the use of nonconventional methods such as meditation.2 Studies have suggested that patients with breast cancer can experience a therapeutic benefit by manipulating the psychosocial environment.5 Some authors propose that psychosocial factors associated with religiosity improve health outcomes.6 Mechanisms have been postulated, but are unproven. Presumably, these effects are mediated by the autonomic, neuroendocrine, and/or immune systems. This patient’s improvement actually seemed to begin several months prior to the encounter with the Russian “energy” healer. She continued to improve after these sessions began. Whether this improvement represents coincidence or a favorable therapeutic intervention is unknown. Certainly, one does not need to invoke paranormal forces or energies to explain a benefit.
What is clear is that anomalous cures of malignant disease, although rare, do occur.7 The factors that produce these unusual cures, including that of the patient under discussion, are unknown. The phenomenon is worthy of further study.
Donald A. Sandweiss, MD
- Koopman B. Psychic healing of a case of glioblastoma multiforme in a three-month-old infant. Sci Rev Alt Med. 2001; 5(1): 9–11.
- Hirshberg C, Barasch MI. Remarkable Recovery. New York, NY: Riverhead Books; 1995.
- Starnes WB. Coley’s toxins, tumor necrosis factor and cancer research: a historical perspective. Pharmacol Ther. 1994; 64(3): 529–564.
- Ruckdeschel JC, Codish SD, Stranhan A, Mckneally MF. Postoperative empyema improves survival in lung cancer. Documentation and analysis of a natural experiment. N Engl J Med. 1972; 287: 1013–1017.
- Spiegel D, Bloom JR, Kraemer H, Gottheil E. Effect of psychosocial treatment on survival of patients with metastatic breast cancer. Lancet. 1989; 2(8668): 888–891.
- Koenig H. Exploring links between religion/spirituality and health. Sci Rev Alt Med. 1999; 3(1): 52–55.
- Sperduto P, Vaezy A, Bridgman A, Wilkie L. Spontaneous regression of squamous cell lung carcinoma with adrenal metastasis. Chest. 1988; 94(4): 887–889.