Cheating Death (25 page)

It’s here where the story takes a surprising turn. Around this corner, medicine and faith came colliding together. A little
flutter occurred somewhere in the universe, and the line between life and death moved once again. Just one week after the
remarkable coming together of people in prayer, Matthew found himself in an MRI scanner once again. Given what had happened
over the previous three months, it was a time of dread for the Pfenninger family. The remarkable prayer service was nearly
forgotten and Matthew steeled himself to the seemingly inevitable.

The MRI results, though, were astonishing. The tumors were gone. Not just smaller, but gone altogether. At first, Jack Pfenninger
couldn’t believe that the scans he was looking at actually belonged to his son—but no, there was the shunt in Matt’s head,
right where the surgeon had left it to drain fluid, and there was the evidence of scarring from his previous operation. Somehow,
Matt’s cancer had simply disappeared. There was only one word the Pfenningers could use to describe what had just happened:
miracle.

A few years ago, a similar thing happened to a man named Charles Burrows, a fifty-six-year-old Army veteran who was diagnosed
with inoperable liver cancer. Two months after the diagnosis, he developed a fever and nausea and started shaking. Within
days, he noticed the pain in his midsection and the obvious lump were gone. At the Phoenix Veterans Affairs Health Care System,
a magnetic resonance imaging scan showed no sign of cancer. There was only “empty space” where the tumor had been, according
to Dr. Nooman Gilani, who examined Burrows at the Phoenix hospital. When a befuddled Gilani did some reading to try and figure
out what he’d seen, he discovered more than two dozen cases of clear spontaneous regression involving liver cancer—where the
patient was completely cured, despite receiving no conventional therapy. One such patient was eighty-five years old.
⁴

It’s not just liver cancer. Oncologists have documented hundreds of cases where tumors, miraculously and mysteriously, simply
went away.
⁵
In 1985, it happened to Alice Epstein, a mathematician and sociologist who was diagnosed with cancer of the kidney. Despite
having the kidney removed, the cancer spread to her lungs and she was given three months to live. She decided against further
surgery or chemotherapy, and yet a year later, the tumors were gone.
⁶

I would be remiss if I didn’t share with you what went through my head when these stories were presented to me. Like many
people trained in the sciences, I tried to come up with an explanation as to what happened. Here is one thought: What if the
answer was already lying somewhere deep in our own bodies? What if their own immune system was suddenly kicked into high gear
and destroyed the intruding cancer cells? A number of people whose cancers spontaneously disappeared have reported sudden
illnesses like the one experienced by Charles Burrows. Perhaps the immune response launched against the infection manages
to blast the tumor as well. It’s certainly likely the immune system is involved somehow, and a good deal of advanced anticancer
research deals with how to goad it into attacking cancer cells.

As a scientist, I am bound to try and explain these rare phenomena, as opposed to simply accepting them as divine intervention
or something totally inexplicable. Having said that, as a medical journalist, I’m always on the lookout for remarkable stories.
When it’s a patient whose cancer spontaneously goes away or a young man whose advanced tumors disappear after a round of group
prayer—well, you might call those cases miracles. But I want you to think—to reconsider—what that term really means.

This entire book is about why some people recover and thrive, even when traditional medical science and even common sense
would write them off. Most doctors will tell you they don’t believe in miracles. What they believe in is working hard, doing
their homework, and never giving up. This is how you cheat death.

*   *   *

D
R. DAVID GORSKI
has a pet peeve with the term “medical miracle.” Gorski is a surgeon and cancer researcher at Wayne State University, who
also writes two blogs, Respectful Insolence and Science-Based Medicine. On Respectful Insolence, under the pseudonym Orac,
Gorski kicked off 2008 with a New Year’s resolution: “Let’s not use the word miracle when we really mean ‘unexpected survival.’
” He says that many miracles would better be credited to first-rate medical care while others are simply the result of random
chance. Calling them miracles can lead patients to miss the real story—and to pursue treatments that are ineffective or even
dangerous.

Take Alcides Moreno, a New York window washer who survived a forty-seven-story fall in December 2007.
⁷
Sure, says Gorski, that takes a lot of luck, but it was the talent of medical professionals who saved him. “What saved the
guy was the concerted effort of a lot of people. That, and all the understanding we have of human physiology,” says Gorski.
⁸

Gorski is a crusader for evidence-based medicine—the idea that therapies should only be used if there is solid evidence to
support them. In the world of cancer, that means stomping on a lot of feel-good stories. One of his mini-obsessions was the
case of Starchild Abraham Cherrix (yes, his real name), a teenager in Virginia who seemingly recovered from Hodgkin’s lymphoma
after a bitter legal battle over his right to refuse conventional treatment.
⁹
Rather than accept his doctors’ recommendation of chemotherapy, Cherrix and his family traveled to a clinic in Tijuana that
offers the Hoxsey method, a sundry mixture of antimony, zinc, bloodroot, arsenic (in a miniscule dose), licorice, red clover,
burdock root, Stillingia root, barberry, cascara, prickly ash bark, buckthorn bark, potassium iodide, procaine hydrochloride
and vitamins, liver and cactus—as well as sulfur and talc—which is applied to the skin.
¹⁰
A court stepped in to block a return trip and forced a compromise whereby Cherrix agreed to see a local oncologist, who gave
him a combination of standard radiation treatment and herbal and alternative therapies. By the fall of 2008, according to
news reports, Cherrix was cancer free.

Along the way in 2007, the state of Virginia passed new legislation, Abraham’s Law, giving families of children age fourteen
to seventeen, facing “life-threatening disease,” the right to pick—or ignore—any treatment they choose.
¹¹
In the headlines, it was a triumph for alternative medicine. For Gorski, that’s ridiculous. “There’s good evidence the Hoxsey
method doesn’t work,” he says. “It’s almost certainly the radiation that shrank Abraham’s tumors.”

That’s evidence-based medicine. Gorski rejects the concept of “healing” sites like Lourdes—where pilgrims have gone for centuries
in search of divine cures—and he rejects the notion that prayer can heal, saying, “It obviously doesn’t work.” That pretty
much sums up the point of view that most scientists take—in public. But I know it leaves a lot of them, myself included, with
nagging questions. Even with chemotherapy, the speed of Matthew Pfenninger’s recovery is remarkable, even astounding. Most
patients would take months to show any sign of shrinking tumors, let alone making them disappear altogether. There are plenty
of cases, popping up all the time, where the recovery does seem truly miraculous—at least, in the sense that a medical reporter
might use it, even if a neurosurgeon wouldn’t.

Sometimes it really looks like someone beat the odds, that the lottery ticket paid off. Maybe it’s a miracle. Maybe prayers
were answered literally, but maybe it’s something else, and in these cases, it is worth digging deeper, as doctors and reporters.
For one thing, you have to consider the possibility of misdiagnosis. In cases that aren’t so well documented as Charles Burrows’
or even Matt Pfenninger’s, it’s entirely possible that the person never had cancer after all. An interesting phenomenon I
have seen occur in hospitals is a type of groupthink. Once a patient is labeled with a particular diagnosis or prognosis,
most of the other health-care team members tend to sign on without scrutiny. That can make a second opinion valuable, if only
to lay fresh, uninfluenced eyes on the problem.

But it gets more complicated than that. The practice of medicine is always changing. There are new discoveries, and new approaches
that may benefit—or harm—particular patients. On top of that, every patient is an individual unlike anyone else, in ways both
known and unknown. For all the value we place on clinical trials and careful research, doctors often make judgments based
on personal experience—or the experience of other doctors they know or read about. These are anecdotes, as in “anecdotal evidence.”
They’re almost dirty words to some people—you can almost hear the sneer when they say, “There’s
only
anecdotal evidence for… ,” but after all, each patient is an anecdote. And the reasons why some people get better while others
don’t are not always obvious.

Another very real possibility is that the person is just plain lucky. No one truly expects to win the lottery, but most times
someone really does have the winning ticket. Here’s the thing: you need to consider the statistics, the chances, the odds.
When we play Powerball, we
know
the true odds. On a single ticket, it’s 195,249,054 to one, if you were wondering.
¹²
But medicine is different. No doctor can be anywhere near that precise. We come up with estimates based on the specifics
of each case, on the published research, and our own experience, but in the end it’s only a guess. Perhaps a well-qualified
and substantiated guess, but still a guess. The doctors who told Mark Ragucci’s family to take him off life support were highly
educated, well-meaning physicians with lots of experience. And they were wrong.

O
N A SUMMER
afternoon in 1996, a thirty-year-old man named David Bailey was hunched over the phone, his grip on the handle getting tighter
with each call.
¹³
He was going down a list, a list he had made of people who might be able to save his life. Bailey, a highly successful salesman
of computer software, was surrounded by half-packed cardboard boxes. Two weeks earlier, on July 4, he and his wife were planning
to spend the holiday getting ready for a move from northern Virginia to the Boston suburbs, where he’d landed a new job. He’d
driven home from Massachusetts the day before, and eleven hours in the car had left him with a splitting headache.

The morning was even worse. Packing would have to wait. Not long after breakfast, Bailey was nauseated and dizzy. He tripped
and fell in the living room. “My wife called 911, and I got on the ambulance, but I thought people were just unnecessarily
worried,” he told me. “That’s the last thing I remember.”

In the ambulance, Bailey had a small seizure, and at the hospital, he had a major epileptic seizure. An MRI of his brain detected
a large mass, and he was rushed into surgery that same day. He awoke four days later feeling better, until he got the news.
“They told me I had six months to live,” he said. “The tumor was a glioblastoma. They said, ‘Good luck.’ ”

Of all the words you might hear in a hospital, “glioblastoma,” or “GBM,” may be the most chilling. Of 126 known types of brain
cancer, glioblastoma is the most common, but it’s also the most deadly.
¹⁴
As with any brain tumor, it is relatively rare, striking about ten thousand people a year.
¹⁵
Also called a malignant glioma, this kind of tumor tends to grow tendrils, arms growing out from the original tumor site.
When I open the brain to perform surgery, I can tell you these tumors look like a little version of the monster in
Alien,
gripping its victim with these evil-looking tentacles. A malignant glioma grows fast—“highly aggressive” in medical terms.
Untreated, it will double in size in just
days
. Just as dangerous, a malignant glioma is “diffuse.” This means that it’s made up of many different kinds of cells, which
respond variously to different treatments. This is important because no single treatment can kill every kind of cell in a
malignant glioma. When I talk to my colleagues in the pathology department, they remind me we don’t even know how many kinds
of cells there are.

Where the illness comes from is not well understood. In the vast majority of cases, the cause is a mystery, and without a
known cause, doctors can’t even tell you how you might prevent it. But all the research on malignant gliomas reveals an incredibly
complex and resilient enemy. For one thing, cells within the tumor constantly and quickly mutate. A biopsy taken during surgery
often looks dramatically different from a biopsy taken when the tumor recurs just a few months later. It’s like a completely
different disease. This variety of cells is referred to as heterogeneity. Heterogeneity is why doctors often prescribe multiple
treatments for cancer patients; what kills one kind of cell may leave others to continue growing. Worse, an ineffective treatment
leaves tumor cells that are resistant, and as they multiply, all the resulting cells will be resistant, too. A single treatment—a
single chemo drug alone, for example—virtually never works.

A glioblastoma is also a physically moving target. According to Dr. Darrell Bigner, the director of the Preston Robert Tisch
Brain Tumor Center at Duke Medical Center in Durham, North Carolina, its cells almost always develop the same ability to migrate
through the brain, as do cells in a child’s developing brain. By the time the cancer is discovered, the cells have usually
crossed to the other side of the brain and sometimes down into the brain stem. For this reason, surgery is never enough to
fully eliminate this type of cancer.

That’s not to say surgery isn’t vital to survival; in the short term, the patient needs surgery to cut away the tumor that’s
pressing on his or her brain. As a neurosurgeon, I’ve learned several techniques that make surgery an even more powerful anticancer
tool than it was ten or twenty years ago. Before any operation, we create a 3-D model of the brain and the tumor, to identify
precisely where the tumor is located and how that relates to the parts of the patient’s brain that are critical to functions
like speech and movement.