Controversial Cancer Therapy which You Ought to Know

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I like to think that one of the more important public services I provide here at Science-Based Medicine is my deconstructions of alternative cancer cure testimonials. After all, one of the most powerful marketing tools purveyors of cancer quackery have in their arsenal is a collection of stories of “real patients” with cancer who used their nostrums and are still alive and well. These sorts of analyses of alternative cancer cure testimonials began right near the very beginning of my not-so-super-secret other blog way back in 2004, metastasized—if you’ll excuse my use of the term—to SBM in 2008, and have continued intermittently to this very day, most recently with a bevy of posts showing why the testimonials of Stanislaw Burzynski’s patients do not constitute good evidence that he can cure cancers considered incurable by “standard” medicine. In other words, Burzynski’s “success stories” aren’t the slam-dunk evidence he and Eric Merola want you to believe them to be regarding the use of antineoplastons to cure brain cancers.

First, let’s take a look at Mr. Wark’s story. Since his story is so simple to deconstruct, I’ll then look at more of the material on his website. Right on the front page of Mr. Wark’s website, there is a brief blurb about him that reads:
My name is Chris Wark. I was diagnosed with stage 3 colon cancer in 2003, at 26 years old. I had surgery, but refused chemo. Instead I used nutrition and natural therapies to heal myself. By the grace of God, I’m alive and kicking, and cancer-free!

Elsewhere, Mr. Wark states:
In December 2003 I was diagnosed with Stage 3 Colon Cancer. There was a golf ball sized tumor in my large intestine and the cancer had spread to my lymph nodes. It was two weeks before Christmas and I was 26 years old.
I started this blog in 2010 to share my story and everything I’ve learned about nutrition and natural therapies for cancer. I didn’t expect it to blow up, but it has.

And here is a video:
Again, regular readers will recognize immediately that this is the most common variety of alternative cancer cure testimonial. It’s so common that I really should think of a pithy name for it. Maybe the “adjuvant gambit”? Basically, such testimonials completely confuse the role of two different modalities (surgery and chemotherapy) in treating their malignancies. Mr. Wark’s testimonial contains the same sort of error about cancer therapy that, for example, Suzanne Somers routinely makes when she relates her breast cancer “cure” testimonial. That error is to confuse the use of chemotherapy for primary curative intent with the adjuvant use of chemotherapy. Many cancers, such as hematological malignancies, are treated primarily with chemotherapy, but solid tumors (i.e., tumors arising from organs) are treated primarily with surgery to extirpate the primary lesion. Most hematological malignancies, if they are going to be “cured,” are cured with chemotherapy and sometimes radiation therapy. Most solid tumors, on the other hand, require complete surgical extirpation to cure them.

The problem, of course, is that many solid tumors have already had cells detach from them and either invade further into the organ or circulate in the bloodstream. Only a very small fraction of these cells can lodge somewhere and form a metastasis, but when you’re dealing with billions of cells or more the risk starts to become significant. In the case of Suzanne Somers’ breast cancer, she underwent excision of her primary tumor, biopsy of her axillary lymph nodes, and adjuvant radiation therapy (although she now says that if she had to do it all over again she would refuse radiation as well). What she did refuse were adjuvant chemotherapy and adjuvant Tamoxifen, the estrogen-blocking drug that was (and still is) commonly used as adjuvant therapy for breast cancers that make the estrogen receptor. No doubt, given her well-known promotion of “bioidentical” hormones as a fountain of youth, Somers did not wish to do anything that would block the action of these hormones. I’m also sure that her doctors almost certainly told her that she needed to knock it off with the bioidentical hormones while being treated for her cancer, a recommendation that was unlikely to have been well-received.

Now here’s the thing. The primary treatment for stage III colorectal cancer is still complete surgical resection. Everything else is icing on the cake. To illustrate this point, I ran an Adjuvant! Online estimate for the benefit of chemotherapy for a patient like Wark, who was 26 at the time of his diagnosis. This is a bit hard to do because I don’t have complete staging information. However, Wark was nice enough to inform his readers that he had four positive lymph nodes and a “golf ball sized tumor.” The latter bit of information doesn’t help, because for purposes of staging size doesn’t matter so much as how far the tumor has invaded through the layers of the wall of the colon, but the first bit of information about how many positive lymph nodes were discovered is quite useful because it tells me, when combined with the size of the cancer, that the original tumor was probably not stage IIIA.

There are also two main chemotherapy regimens for colorectal cancer. One is basically 5-fluorouracil (5-FU) plus leucovorin and has been the mainstay of treatment of colon cancer for decades. However, over the last 10 or 15 years, a newer, more effective regimen known as FOLFOX has been developed that include 5-FU, leucovorin, and oxaliplatin. There’s also an even newer regiment called FOLFIRI that is 5-FU, leucovorin, and irinotecan, but that one is not yet in Adjuvant! Online. So I’ll stick to 5-FU and FOLFOX. What I did was to enter information provided by Mr. Wark on his website into Adjuvant! Online and make educated guesses about the rest in order to provide you with a graph that shows a ballpark range for the survival benefit that adjuvant chemotherapy would provide him. First, here is stage IIIB disease plus 5-FU-based regimens:

Stage IIIB 5FU
Next, here is stage IIIB disease and FOLFOX:
Stage IIIB FOLFOX
In both cases, with surgery alone, Mr. Wark’s odds of surviving five years are around 64%. That’s pretty good for such advanced disease, but we can do better. 5-FU-based chemotherapy regimens increase those odds by around 12% to a 76% chance of surviving five years. FOLFOX, as you can see, does even better, increasing the odds of surviving five years by around 16%, all the way to 80%. Since colon cancer, unlike, for example, breast cancer, rarely recurs after five years, five year survival rates in colon cancer are pretty close to equivalent to the chances of being “cured” of colon cancer. So basically, by eschewing chemotherapy, Mr. Wark decreased his chances of surviving his disease by approximately 12-16%. Since his odds of surviving his disease with surgery alone were greater than 60% to begin with, although he was lucky that his refusing chemotherapy didn’t put him into that 12-16% of similar patients for whom chemotherapy prevents a recurrence, the odds of his surviving were still in his favor if my educated guess about his stage at diagnosis is reasonably accurate. If, however, I underestimated his stage and he had stage IIIC disease, the argument for chemotherapy would be even stronger:

Stage IIIC FOLFOX
Note that in this graph, Mr. Wark’s odds of surviving 5 years with surgery alone would only be 30%, with FOLFOX chemotherapy increasing the odds to around 55%, nearly double. Of course, even in this extreme case, 30% is around a one in three chance; so survival without chemotherapy would not be that unusual. Although he would, in this case, have to be quite a bit luckier than in the case of stage IIIC disease, his survival would not be so unusual that it could be attributed to whatever woo he decided to partake of. Sadly, as is evident in an e-mail from Mr. Wark reprinted in a credulous article about his story, Mr. Wark does not understand the basics of adjuvant chemotherapy, or, if he does, he is not relating it correctly:

Surgery does not cure cancer, especially not stage 3. If it did, that’s all they would do. There would be no need for chemo and radiation. The medical industry has known that surgery does not cure cancer for at least 100 years. Cancer is a systemic metabolic disease, the result of a body that is nutrient deficient, overloaded with toxins, and has an overloaded or suppressed immune system. If the body is not given the essential nutrients it needs to repair, regenerate and detoxify, cancer will most assuredely [sic] come back after surgery. A diet rich in fruits and vegetables, juices and smoothies is the most powerful way to promote the body’s ability to heal itself. All processed food must be eliminated. Animal products should be severely restricted or eliminated for a season until the cancer is gone. And it’s ok if some people don’t believe me. I know lots of survivors that have healed cancer without surgery, but skeptics won’t believe them either.

He is, quite simply, wrong that surgery does not cure cancer. For solid tumors like colon cancer, surgery is almost always the only way it can be cured. Indeed, even in the case of some stage IV disease (specifically, metastases to the liver), surgery can still “cure” colorectal cancer. Be that as it may, Mr. Wark had an estimated 30-64% chance of being “cured” of his cancer by surgery alone. However, those odds aren’t good enough. Why should they be, when we can make them significantly better with chemotherapy? It is sad that Mr. Wark decided to decrease is odds of surviving his disease, particularly given how young he was at the time of diagnosis. It is even sadder still that he has decided to dedicate his life to persuading other cancer patients to make the same foolish choice that he did. As for “survivors that have healed cancer without surgery,” as I have shown time and time again in other contexts, these stories rarely stand up to scrutiny either. In any case, looking at his testimonial, I see that his oncologist estimated that he had a 60% chance of survival. It’s not clear whether that is with or without chemotherapy, but most of the time oncologists assume that the patient will accept standard-of-care therapy. That’s why this piece of information makes me think that Mr. Wark was closer to a stage IIIC than IIIB and therefore leads me to believe that Mr. Wark took an even bigger chance with his life than I had originally thought.

It’s also instructive to take a look at the naturopath who treated Mr. Wark, a guy named John Smothers. Perusing his website you will find the usual naturopathic nonsense about “detoxification,” chronic Lyme disease, “anti-aging” diets, and the like. On Mr. Smothers’ page on cancer, you will find metabolic blood tests, anticancer diets, intravenous vitamin therapy, detoxification, infrared sauna treatments, enzyme therapy, lymphatic massage, and something called Theotherapy, which purports to “release destructive emotional patterns that cause weakness in the body through prayer and grief processing. The body is a slave to the soul. What is in the soul will manifest itself into the physical body. Patterns of unforgiveness will lead to breakdown. Forgiveness must come from the heart. Most of the time this is in many layers.” In other words, Mr. Smothers offers the usual cornucopia of pseudoscience and mysticism that naturopaths love so much, and Mr. Wark has completely bought into it. Indeed, take a look at his reasoning (such as it is) for refusing chemotherapy:

Right from the start, it’s easy to tell that Wark’s reasoning will not be sound. He talks about how nurses have to wear gloves and try to protect their skin from chemotherapy while expressing horror that this is the same stuff that is put into patients’ veins. Of course, patients go through their chemotherapy for six or nine or twelve months—or whatever regimen—and get dosed once every one to three weeks or so. Nurses deal with the substances day in and day out on a chronic basis, possibly over many years. The two are not comparable situations. Next, Wark refers to chemotherapy as “poisoning your way back to health.” Well, yes and no. Sometimes, as Nick Lowe would say, you have to be cruel to be kind (in the right measure). Yes, chemotherapy is toxic, but it works and, unfortunately, we haven’t found anything that works as well yet. Perhaps the silliest thing Wark says in this video is that he has to “believe” in the therapy he chooses and that “if I really believed in chemotherapy maybe it would’ve worked.” Here’s a hint: Truly effective anti-cancer therapy doesn’t require you to “believe” in it. As has been said before, you can be in a coma, and antibiotics will still cure your pneumonia. In the same way, you can “disbelieve” that chemotherapy can treat a cancer, and it will still work. Wark also doesn’t help his case by citing the “2% gambit” about chemotherapy, which is misleading trope beloved of cancer quacks the world over. Wark is no exception.

His last trope is that chemotherapy destroys the immune system. He discusses how, if you have cancer, it is the immune system that is keeping it in check and the reason that it’s “not all over your body.” Well, not exactly. He seems to forget that if his immune system had been as awesome as he thought it was he probably would never have grown a golf ball-sized tumor in his colon that spread to his mesenteric lymph nodes in the first place. Of course, his explanation is that it’s the “toxins” that overloaded the immune system and let the tumor develop. He then brings up an example of the patient who undergoes surgery and chemotherapy, thinks he’s tumor-free, and then a few months later develops widespread metastatic disease. To Wark, this is because chemotherapy “destroyed the immune system.” Yes, chemotherapy, depending on which drugs are being used, can temporarily suppress the immune system, but it doesn’t destroy it. The immune system is quite good at rebounding after chemotherapy is done, and the destruction of the immune system is not the main reason why cancer can recur after a seemingly successful treatment. It’s because our treatments aren’t yet good enough to eliminate every last cancer cell. Some can go dormant, only to emerge later.

Of course, Mr. Wark’s testimonial is not enough. He’s begun to collect testimonials of his own. The vast majority of them don’t provide enough information to tell me one way or the other whether there’s anything to them or not. I might have to take a look at a couple of them in more detail in the future, but for now I’ll “cherry pick” a couple. Most of them are maddeningly vague, although some have fairly obvious explanations. For example, Ann Cameron claims to have cured herself of stage IV colon cancer with carrot juice. She had stage III colon cancer, underwent surgery, and refused chemotherapy. Later, she was noted to have lesions in her lungs suspicious for metastases. These supposedly disappeared with carrot juice. However, there is no record of any of these lesions having been biopsied. A PET scan showed “spots” that looked like lymph nodes, but again there is no mention of these lesions ever having been biopsied. My conclusion? These almost certainly were not metastatic cancer.

Next up is a man named Jeffery Williams, who was diagnosed with stage III testicular cancer. He underwent surgery to remove the testicle but was found to have a mass in his abdomen. What follows is a prolonged story of his refusing chemotherapy, using megadoses of carrot juice, and following the Hallelujah Acres Diet, with Angstrom ionic liquid cesium and potassium, Solaray Tumeric and Essiac Tea, along with insinuations that his doctors lied to him about the tumor in his abdomen. At one point, he says he couldn’t find a doctor willing to biopsy the mass, which sounds very odd given that an abdominal mass that’s suspicious for tumor in a patient with a history of testicular cancer almost mandates a biopsy. Finally, a biopsy supposedly showed “100% dead cancer cells.” Of course, a biopsy showing “100% dead cancer cells” does not mean that therapy was working; it could simply mean that the tumor outgrew its blood supply, its center died, and the biopsy (presumably a needle biopsy) only got the center of the tumor. Be that as it may, this is what Williams describes after that:

I also found a surgeon who was willing to remove my tumor. On April 20th 2010 I had a 9.5 hr. surgery to remove the tumor at Cleveland Clinic. I received 4 inches of incision from my first surgery in 2009 and 26 inches of incisions on my second surgery on April 20th 2010. I have had a cat scan once a year since April 20th and I have had no problems.
One notes that he doesn’t say what the pathology showed that the tumor was, which is by itself quite odd. The whole thing sounds very fishy, but even if the story is as Williams represented it, it sounds as though two operations cured him. Even odder still, if Williams was so convinced that his “natural” treatments had cured him of his tumor, why on earth did he go to such lengths to find a surgeon willing to resect the mass? As I said, the pieces of this testimonial don’t all fit together.

Of course, there are breast cancer testimonials, including those of Monique Norton, Susan Macco, and Ashlie Sanders (who appears to have had her entire tumor removed by the biopsy). They’re all of the same variety as Suzanne Somers’ testimonial. They all underwent surgery and eschewed other therapies, meaning that the surgery cured them. They all attribute their survival to whatever quackery they chose to pursue rather than the surgery. I’m tellin’ ya, as a breast cancer surgeon I sometimes get depressed at how little credit we are given.

As glad as I am to see a cancer patient overcome the odds and beat his disease, it’s truly depressing to see that same patient spread misinformation about the science-based medicine that saved him and then to promote all sorts of quackery. Look at his Resources page, for instance. It’s a veritable cornucopia of quackery, up to and including Hulda Clark and Bob Beck, Gerson therapy, Ty Bollinger, Russell Blaylock, and more. Worse, he hides behind a variant of the quack Miranda warning in which he prefaces his advice with “I’m not a doctor and can’t give medical advice,” after which he basically gives medical advice. A great example is in response to a question from a 32 year old woman with breast cancer who has undergone surgery and is understandably frightened at the prospect of beginning her chemotherapy. Here’s Wark’s response:

I’m not a doctor and can’t give medical advice, but obviously I chose not to do chemo because yes, it does destroy your immune system, and it is also a carcinogenic substance. I decided to do every natural therapy I could find FIRST. If none of it worked, then chemo would be my last resort. That was my plan.
Doctors do not control your life, you control your life.

Two of my favorite quotes:
“Courage is not the absence of fear, but the realization that there is something more important than fear.”
and “If you’re scared, Do it scared.”
My opinion is that mainstream cancer treatment does more harm than good. That is my opinion.
Your cancer could be all gone, but your body may still be a place where new cancer cells could thrive. This is why it’s critical to get hardcore about your health, which it sounds like you’re doing already.
If you decide to postpone chemo, there is a support system for you that I can help you connect with.
All of which sounds very much as though Wark is trying to dissuade this woman from undergoing chemotherapy. He does this even though he tries to cover his behind with a disclaimer like this:
I am not a doctor.
I don’t prevent, diagnose, treat, or cure disease.
I do not practice medicine.
I have no certifications of any kind and I don’t plan on getting any.

What I do have is nearly 10 years of experiential expertise. As you can tell by the vast amount of info on this site, I am an avid researcher on nutrition and natural therapies. I am deeply immersed in the alternative health community and I know many people who have healed themselves.
We can learn from the experiences of others. That is how I healed my body of cancer. Whatever your health challenge (cancer, heart disease, diabetes, obesity, high blood pressure, etc.) I am confident that YOU can heal it.
Chris Wark charges $100 an hour or $175 for two hours to impart his “healing wisdom” to you. One wonders how many people with cancer this not-a-doctor has led astray, potentially to their demise, and how what he is doing isn’t practicing medicine without a license.

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