22nd May 2009.
Commentary by Kara Kelly MD.
There are a number of important issues in the Hauser case:
1) Hodgkins Disease is an incredibly treatable form of cancer with conventional chemotherapy and radiation therapy (prior to chemotherapy and radiotherapy it was hardly ever cured). The USA Today story is correct that the prognosis is greater than 90%. I chaired a national clinical trial through the Children's Oncology Group that demonstrated that for patients like Daniel (our study included patients with stage IIB Hodgkin lymphoma), the 5 year event free survival was 93% and overall survival 97%. There were no relapses specifically among patients with stage IIB disease. Without further treatment, he will die of his lymphoma. One cycle of chemotherapy is not sufficient, and especially in someone like him who has had some progression of the size of the mass on X-ray study while the family delayed treatment and sought additional opinions (from what has been reported in the news). But even with this delay, he can still be successfully treated with chemotherapy with or without radiation therapy, as even relapsed patients have a reasonably good chance (>50%) with more therapy.
2) Another very important issue that I have not seen adequately represented in the news reports, so far, is the practice of integrative oncology, the combination of complementary practices used in conjunction to help support the patient with cancer through conventional chemotherapy and radiotherapy.I know the pediatric oncologist involved in this case. He is quite pained by the events that have occurred. He is a very strong advocate for integrative oncology; he actively encourages the use of complementary modalities for symptom control and he encourages the study of therapies such as curcumin and other herbal therapies that may be useful in the treatment of cancer. His center, Childrens' Hospitals and Clinics in Minneapolis, developed one of the first centers for complementary medicine in pediatrics, similar to the program we have at Columbia. I have found that by using safe complementary therapies to support the child through treatment, this approach allows families to maintain their belief systems about nonconventional approaches but yet ensure that the child receives the chemotherapy necessary to cure the cancer. Many cancer centers offer integrative therapies in conjunction with standard conventional treatment....Today it's not just about oncologists pushing harsh chemotherapy treatments without regards for their side effects.
3) I also think it's important to make the public aware of initiatives that professionals like myself are doing to try to develop integrated approaches. The Society of Integrative Oncology is a non-profit, multi-disciplinary organization of professionals dedicated to studying and facilitating cancer treatment and the recovery process through the use of integrated complementary therapeutic options. Such options include natural and botanical products, nutrition, acupuncture, massage, mind-body therapies, and other complementary modalities. The mission of the society is to educate oncology professionals, patients, caregivers, and relevant others about the scientific validity, clinical benefits, toxicities, and limitations of state-of-the-art integrative therapies. SIO advocates for responsible public policy and the highest standards of practice in integrative medicine through appropriate training and the certification of health care professionals.
Kara Kelly MD
SIO Executive
Associate Professor, Pediatric Hematology, Columbia University Hospital, New York, NY.
Integrative Oncology Researcher; Principle Investigator in Childrens Oncology Group (COG).
