I closed the office in June for a few weeks and escaped to Italy with my wife, Deborah. We didn't cruise or tour by train. This was going to be a time to relax and look at the beach or countryside leisurely. It did give me the opportunity to try out my tourist Italian, which frequently brought blank stares and replies of "che?" Our only surprise and regret was the overwhelming level of graffiti overtaking Rome and many towns. Let us hope that the Italians have not become too despondent to keep the city and monuments lovely.

Dr. Jeffrey Bland
In the June 2009 issue of Elle, an article titled "Tune Up" asked whether one could address chronic health symptoms with a "three-day cleanse." Generally these self-help magazine features don't interest me, but Deborah made me aware that the article focused on Dr. Jeffrey Bland.

I have had the pleasure of knowing Dr. Bland since 1977, when I moved to the Pacific Northwest to initiate my training in holistic, orthomolecular, and naturopathic medicine. I had gone to work for Leo Bolles, MD, in Bellevue, Washington, to administer and examine chelation, alternative cancer and arthritis treatment, and nutritional medicine. Dr. Bolles had arranged for Dr. Bland to set up an adjoining clinical laboratory, not just for the usual blood and urine studies, but to establish tests to measure and define "functional" levels of nutritional need. The recommended daily allowance suggested a minimal level of daily intake of a nutrient but did not consider that some individuals would need more, some less. At the time, such studies were not well developed or available. I remember the success shared at the lab when Dr. Bland implemented a technique to measure the red blood cell level of vitamin B6 (pyridoxine). The camaraderie we shared was as important to me as the medical and biochemistry developments.

Elle freelance writer Joseph Hooper lauded Dr. Bland for his trailblazing in functional medicine. Hooper noted the work that Bland has done over the past three decades instructing physicians, health professionals, and researchers about functional medicine. Hooper recognized Bland's scientific authority as a professor of biochemistry and how he has devoted much of his life's work to understanding the role of biochemistry and nutrition in explaining the physiology of detoxification. That work led to a collaboration in the mid-1980s through the early 1990s with Nobel laureate Linus Pauling. Dr. Pauling's late life study in nutrition led to his advocacy of orthomolecular medicine for treating disease. Bland incorporated much of Pauling's thinking in functional medicine. The Institute of Functional Medicine, a think tank and training institute in Gig Harbor, Washington, was founded by Bland in the 1980s. It is very gratifying to see that he is being given recognition in the lay press. We have been made aware that he is being asked to join advisory groups to explain the role of functional medicine as the health insurance debates unfold.

Congratulations, Dr. Bland!

Dr. Claude DeShazo's Renewal
The focus of this issue is on complementary and alternative treatments for cancer. While we look at alternatives, it is rare for a physician or patient to disengage from all forms of conventional treatment. Although preliminary cancer screening is addressed in leisurely fashion, emergent symptoms such as bleeding or a newly discovered lump are examined with urgency and great worry. If the diagnostic procedure confirms cancer, the treatment strategy is designed to begin immediately with little time for the patient to seek second opinions. The entire process is overwhelmingly complex and very disruptive to patient and family. While some cancer treatment centers attempt to provide counseling and planning calendars to schedule surgery, chemotherapy, radiation, and related treatment, many patients fail to comprehend much of the process before it is undertaken. Further, they are often forced to fill in the gaps in the education process when there are no answers.

The emotional roller-coaster, trying to remain rational with the pervasive fear of an uncertain outcome, makes decision-making for the cancer patient very difficult. How does one advocate for oneself when the wrong decision may make the outcome worse? The lack of time to ensure that all questions are answered and all decisions are thought through before commitment makes the cancer treatment process lack full medical consent.

Claude DeShazo, MD, worked as a general surgeon in a Seattle-area community hospital. Much of his work focused on cancer, particularly breast, lung, and colon cancer. Hence his practice registry was filled with cancer patients. Dr. DeShazo was conscious that the needs of the cancer patient were quite different from those of patients having hernia surgery or appendectomy. He also recognized that those needs could not be addressed in office consultation. While many patients questioned the scheduling of chemotherapy or radiation, others had concerns of a broader medical nature, such as that of what caused their cancer. When patients were scheduled for chemotherapy and radiation, but the odds were not high for survival with these interventions, many asked about alternative therapies and unconventional approaches. Again, Dr. DeShazo did not have the answers for many of these questions, nor the time to approach them in the office. For many patients, the stress of having to cope emotionally with their disease, supporting their families, and dealing with anxiety and depression called for counseling support. They would look to Dr. DeShazo to provide that counseling in the office – and he did offer some counseling during short surgical consultations, even if it did put him behind.

Renewal is an unexpectedly poignant account of the personal stories of members of the group. They met first in Dr. DeShazo's office, then in a shared room at a local hospital, and finally in their own quarters at a nearby newly built hospice center. Meeting every Monday afternoon for a one- to two-hour session, patients, family members, and friends shared their stories, asked questions, raised issues, offered opinions, and just listened. Perhaps most importantly, the group, which met for more than 20 years, showed that talking and listening offered more hope for the cancer patient than the treatments alone. The Renewal group was not about discovering a new cure – it was about learning to live, renewing one's life. Yes, Renewal members shared their thoughts about alternative therapies. Even more, they talked about diet, exercise, meditation, and visualization, as well as coping with cancer treatment. They bonded, forming strong friendships, and learned to forgive.

Renewal was not about creating the statistically longest-surviving cancer group. It was about learning how to live with a life-threatening illness. Many members expressed happiness and contentment that they had never had before joining the group. Perhaps most surprising about the book Renewal were the stories of physicians who developed cancer or other serious illnesses. The physician as a patient brings a perspective that most health professionals lack.

I would strongly recommend that all physicians involved with cancer care consider starting their own "renewal" group.

Dr. DeShazo's book is a very important read – not just for the physician but the patient and family members.

Dr. Nicholas Gonzalez on William Donald Kelley, DDS
Occasionally I get feedback from readers who would like to see our magazine improve. A recent mailing critiqued our contents page and the publisher's letter. We apparently are too verbose in our description of articles – definitely not short and sweet like People or US.

I'll grant that the publisher's letter may be lengthy, but that's because I like to say a few words about the author or bring up a historical perspective. Too often, people tend to package alternative medicine into convenient categories like "body-mind medicine," "naturopathy," or "native medicine." Unfortunately, such labeling disregards many other facets and faces of natural medicine.

It is difficult to ignore the power of many of the heavyweights of the alternative cancer field like Max Gerson, MD, or John Beard, PhD – neither of whom fits conveniently under any category. We are pleased to offer our annual cancer issue that seeks to examine those treatments and individuals which cannot be characterized simply. I think that we have provided here a look at some of the people who have changed the way we regard cancer treatment, who don't necessarily think that cure always starts with chemotherapy and radiation, and whose therapies requires education and commitment from physician and patient to explore a different way.

Dr. Nicholas Gonzalez, MD, is one of the alternative cancer field's heavyweights. His practice in New York City is extremely busy with referrals not only locally and nationally but internationally. His work has been recognized by the National Cancer Institute, and his case reports of pancreatic cancer have led to a federal study. Gonzalez's cancer treatment is a highly specialized nutritional protocol that focuses partially on high doses of pancreatic enzymes. The theory of using pancreatic enzymes and specialized nutritional treatment is based on work initiated by a dentist, Dr. William Donald Kelley. Dr. Kelley had a singular reason for his interest in cancer – he was diagnosed with it as a relatively young man and was facing a dismal prognosis. His recovery led to his departure from the dental field and entry into studying cancer and nutrition.

Dr. Gonzalez explores in this issue Dr. Kelley's story, not on the basis of historical reviews or letters, but from direct experience working with him. Many of us have known about Kelley, but Dr. Gonzalez details the inside story and offers the insights he gleaned that have been incorporated into his practice. Additionally, Dr. Gonzalez shares case reports from his practice. It has been commonplace for medical boards to deride case reports as anecdotal; I think the cases reported by Gonzalez provide us reason to reexamine our views of case reports and their meaning in science.

Hyperthermia at Klinik St. Georg
In 2007, we extolled the alternative cancer work going on in Germany. The Germans do not separate alternative medicine from mainstream medicine; unlike their US colleagues, German physicians are allowed to integrate alternative therapies and diagnostic procedures in conventional practice. At the Klinik St. Georg in Bad Aibling, Germany, Dr. Friedrich Douwes administers hyperthermia as a primary treatment for cancer. His experiences are reported in this issue by writer, educator, nutritionist, and spokeswoman Dr. Shari Lieberman, PhD. While Dr. Moss reported during the past year of one physician in the US implementing hyperthermia in a controlled, experimental protocol, hyperthermia is well recognized in German oncology as an important tool for late-stage cancer.

The take-away message is that here is a very important treatment tool, not used in the US, available for physicians to consider in metastatic cancer resistant to further chemotherapy and radiation treatment. Unfortunately, most major cancer centers will not offer this alternative. It is vital that we look at hyperthermia as a treatment option for cancer that is going badly – and for some patients to consider in early cancer care.

Jonathan Collin, MD