Part 4

"Keep in mind that the 5 year mark is still used as the official guideline for "cure" by mainstream oncologists. Statistically, the 5 year cure makes chemotherapy look good for certain kinds of cancer, but when you follow cancer patients beyond 5 years, the reality often shifts in a dramatic way."-Dr. John Diamond MD

The MD Anderson Comprehensive Cancer Center was sued in August,1998, for making unsubstantiated claims that it cures "well over 50% of people with cancer." - Professor Emeritus Dr. Samuel Epstein

Dr Roehrich was on his way to the John Hunter Children's Hospital to visit Lisa and to have a conference with her treating oncologist Dr. A. The last court order had stated that Dr. Roehrich had visiting rights to Lisa as her primary care doctor. However, the last time he tried to visit, he was told he would have limited access to her and a hospital staff member would supervise his visits. This was by order of Dr. A, who had also refused to allow Dr. Roehrich access to Lisa's pathology results. Today however, he had finally been successful in getting an appointment with Dr. A to discuss a matter that was becoming of increasing concern to him.

Dr. Roehrich's appearance was that of a kindly 59-year-old doctor, bespectacled and conservative. His mild mannered demeanour, however, belied the fact that he was a board certified specialist general surgeon and trauma surgeon, which he'd practiced in a busy European teaching hospital until 1982 when he opened his practice on the NSW Central Coast. He also held a Ph.D in Medical Physiology and was particularly knowledgeable in biochemistry and the role of nutrients in disease.

In his medical practice he was used to liasing with specialists and found it important for the sake of all concerned, to maintain good relationships with colleagues. That was the basis for a multidisciplinary approach, where a team worked together for a good patient outcome. But the Eastleigh's case was unusual for a number of reasons. And now he had a new role as arbitrator between Lisa's treating doctor and the parents. By now, the Eastleigh's were clearly upset about what they considered a heavy handed approach and lack of convincing information about the chemotherapy treatment Lisa was forced to undergo.

World's Best Practice

According to the National Cancer Institute, about one-third of all cancer deaths are related to malnutrition. For cancer patients, optimal nutrition is important. Cancer can deplete your body's nutrients and cause weight loss. Cancer and cancer treatment can also have a negative effect on your appetite and your body's ability to digest foods. These factors may leave you in a vulnerable condition - high nutrient need, and low nutrient intake. Dr. Roehrich had many patients in his own practice who were undergoing chemotherapy and some of them came to him for additional

complementary treatments such as nutritional support and acupuncture. This was called integrative medicine and it combined orthodox medicine with proven complementary and alternative approaches. More recently he had done post-graduate studies in orthomolecular (nutritional) medicine, which he employed successfully in his practice on patients with a variety of conditions. (50) In combining these approaches he was in keeping with best practices in major cancer treatment centres around the world including the Memorial Sloan-Kettering Cancer Centre which states on its website: "The Integrative Medicine service at Memorial Sloan Kettering was established in 1999 to complement mainstream medical care and address the emotional, social and spiritual needs of patients and families…Integrative medicine combines the discipline of modern science with the wisdom of ancient healing."

The world's largest cancer institutions have had to integrate their approaches because too many people were opting for the proven benefits of complementary and alternative medicine. To ignore those approaches would have meant a loss of trust on the part of discriminating patients who want every possible opportunity for recovery. A US study at M.D. Anderson Cancer Centre showed that 83% of cancer patients used alternatives. The Huston Texas based cancer centre is the world's largest with over 13,000 patients and offers a wide variety of orthodox, alternative and complementary treatments.

Like top cancer treatment centres Dr. Roehrich's experience also showed that cancer is a complex disorder that requires a multidisciplinary approach. He believed that a patient's survival was dependent on being able to have faith and trust in their caregivers and in the treatments they were receiving. That meant patients needed to have a choice in their treatment so they could participate in the process of recovery. He doubted a positive outcome could be achieved if a particular treatment was forced on a patient.

So far, Dr. Roehrich was very impressed with the skill of both surgeons, Dr.Cassey and Dr. Dilley, who had operated on Lisa. As a surgeon, he realised how successful skilled cancer surgery could be in producing good survival rates. Following the surgery Lisa reverted back to the control of the oncologists, Dr. A and Dr. M whose treatment modality is chemotherapy. As far as Dr. Roehrich was aware, the parents also felt grateful to the surgeons, but the chemotherapy, mandated by the oncologists was another matter and it had become the sticking point for them. In his role as peacemaker, he found it ironic that he was now in a position of defending the use of chemotherapy and explaining its use to the Eastleigh family so they could be reassured. Being their doctor he was keenly aware of the sleepless nights they were having, and he felt they needed help in dealing with Lisa's treatment.

However, in order to help the family understand the basis for Dr. A's prescribed chemotherapy for Lisa, he felt duty bound to first review the medical literature himself. Not long after Lisa's attempt to flee the hospital, Dr. Roehrich took some time one evening to conduct a search of the world's scientific studies on outcomes for treatment of Lisa's type of cancer using the chemicals she had been prescribed. The most prominent study was the same UK study, (UK CCSG (GC2), that both Dr. M and Dr. A cited was the basis for their decision to implement Lisa's present chemotherapy by Court order.

Apart from his medical degree and specialist qualifications Dr. Roehrich had spent several years conducting scientific research. He was versed in strict laboratory protocols and statistical language. He became immersed in the scientific study the oncologists cited and soon was troubled by what he saw. Both oncologists claimed that Lisa would have an 85% chance of a cure from cancer if she had their chemotherapy treatment. Both based this on the UK CCSG (GC2) study (51)

On December 12th 2002, Dr. A had made a note in Lisa's medical records that she had "0% chance" of survival if she did not have his treatment. The abovementioned study he based this on did not have a control group to compare other treatments, which meant there was no evidence in that study to support Dr. A's assertions that she would die without his treatment. As to the claim of an 85% cure rate with this treatment, the figures given in the study pertained to a five-year survival rate only.

In the science of epidemiology the word "cure" means an event free normal lifespan comparable to a healthy peer group. A five-year survival rate does not by any standard support the oncologists assertions of a cure. Dr. Roehrich came to realise that those unsubstantiated claims had formed the basis for the DoCS intervention and Court order to treat Lisa against her will. This compounding error had had a devastating effect on all concerned. The family was broken up by DoCS. The parents were facing mounting and crippling legal costs to defend themselves against the relentless legal battering from DoCS. Their medical costs were escalating. James had missed months of work, which further worsened their financial situation. Lisa's health was deteriorating. She was beside herself with worry. Since shortly after the last court order Lisa was put on suicide watch.

Dr. Roehrich arrived at the hospital Wednesday August 6th at 4:30 pm. Dr. A had allowed him 20 minutes with Lisa. The hospital had a list of people who could visit or phone her. Lisa could not see her friends, as they were not on the list of people allowed to visit. Only immediate family, and only for two hours. It was done by court order for Lisa's "protection". Dr. Roehrich was not prevented access to Lisa's records by court order but rather by the order of Dr. A.

He sat at Lisa's bedside and a nurse sat on the other side of the bed, watching closely. Conversation was difficult. Lisa seemed reluctant to say anything at all, a far cry from the elfin pranksterism she'd displayed around the doctor before she was made a ward of the Court. She'd had her room searched previously and staff had confiscated from her carry case, the vitamins Dr. Roehrich had prescribed for her two months previously. She seemed keenly aware of her lack of privacy and had made no notations in her journal. The doctor asked if she had gone to play therapy. She said "no" and indicated she doesn't feel like it.

She had not participated in music or art therapy. Once an excellent student, she told him she attended hospital school occasionally, but did not seem interested in the subject. She played with her key ring and fingernails and ignored the nurse, making no attempt to interact with her. Dr. Roehrich made a mental note that Lisa seemed anxious at times but appeared primarily shut down emotionally. He did not know how she would tolerate another few months under these conditions of captivity. He had on a previous visit asked the nurse's permission for the three of them to go for a supervised walk around the hospital grounds so Lisa could get some fresh air and sunshine, not only to lift her spirits but also to provide her with adequate vitamin D from the sunshine. However, this was refused. He noted that Lisa looked frail. She had lost 20% of body weight since she had had the first chemotherapy treatment, which placed her significantly underweight for her height and age.

Dr. A and Dr. V, director of Hunter Children's Health Network, came to collect Dr. Roehrich after his 20-minute allotted visit and took him to a private conference room. The hospital doctors both expressed their surprise that Dr. Roehrich, as the family GP had taken such a keen interest in the case of Lisa. Dr. Roehrich agreed that the case is indeed unusual. He usually did not feel the need to get involved with a patient's hospital treatment. And though he was not part of the specialist team, he had never felt so disturbed by a case before.

Dr. A explained the reason for the strict supervision was that they were intent on preventing any alternative therapy from being administered. Dr. Roehrich assured him he had no intention of administering complementary or alternative therapy at this time, let alone on the sly, (despite the fact that major cancer centres all over the world integrate these modalities). Dr. Roehrich's concern however was the fact that Lisa suffered from major nutritional deficiencies owing to her illness and two operations, the present stress, a diet that is foreign to her, her refusal to eat due to her unhappiness, and her very significant weight loss. This could diminish her chances of survival due to malnutrition alone.

Dr. Roehrich explained that this could be rectified by allowing her to have the essential supplements to correct this, and to allow her to eat the diet to which she is accustomed. This required only a phone call to the dietician. Dr. A declined this suggestion. "You may talk to my dietician," he said. "But she will report to me, and right now we want Lisa on the hospital diet."

Dr. V was mostly silent throughout. Dr. Roehrich decided to broach the subject that made him feel most uneasy about the matter. He said he'd reviewed the scientific literature upon which Dr. A is basing his treatment and prognosis, and upon which DoCS has intervened with such force, and upon which the Court has made its decision to uphold these plans. Dr. Roehrich told him of the lack of evidence for his assertions that Lisa would die without his treatment and with them she would be "cured". Dr. A replied, "Well that's all we've got."

Dr. Roehrich spent the next hour's drive home immersed in his thoughts. He could not imagine what medical reason the doctors had for keeping Lisa confined for months in the hospital when other children are allowed to go home between cycles of chemotherapy. He could not imagine how any doctor could sleep at night knowing there was a child under his "care" who was a captive of his treatment; a treatment whose scientific basis he had misrepresented. Was his colleague not perturbed by a child who wanted to take her own life because she could not imagine living without her family? Dr. Roehrich could not imagine, even in war torn countries, that children would deliberately be denied essential nutrients to prevent the effects of malnutrition. He could not account for a reason why Dr. A would insist on a treatment that is so far outside the best practice of mainstream cancer treatments, as to be at odds with not only good medical practice, but that also denies this child her most basic human rights.

Dr. Roehrich had petitioned the court to allow him to brief an oncologist with an integrated approach, to address Lisa's debilitating health problems. A number of colleagues had already expressed an interest and many doctors have expressed their concern as to the way this matter has been handled.

On Friday the 8th of August the DoCS legal representative met with James and Elizabeth. He told them that they would never have another opportunity of giving their daughter vitamin or mineral supplements again. He told them she could be placed into a foster home. Permanently.

The author asserts copyright, but this article may be distributed for non-commercial purposes. For any other purpose please contact the author at; evehillary@smartchat.net.au

About Eve Hillary

Eve Hillary is based in Sydney. She a medical analyst and writer on issues pertaining to the health care industry and environmental health.

She is the author of Children of a Toxic Harvest: An Environmental Autobiography, and numerous articles relating to health issues. Her most recent book is Health Betrayal; Staying away from the sickness industry. She is also a public speaker.

Eve has spent 25 years in health care where she has observed the medical industry at first hand from the inside.

    

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