Cancer Complementary and alternative medicine Medicine Quackery

Following up on a very old case: Abraham Cherrix is alive and well because he finally rejected alternative medicine

Eleven years ago, Abraham Cherrix and his parents chose quackery over science-based medicine to treat his cancer, and Cherrix was one of the earliest cases of teens who chose quackery to treat a life-threatening disease that I discussed in depth. Recently, I learned that Cherrix is still alive. The reason? He finally realized the error of his original decision and underwent chemotherapy and a bone marrow transplant.

One of the gratifying things about having been blogging so long—nearly 13 years now!—is that you start to see stories that you wrote about a long time ago resurface, allowing you to see the resolution. For instance, I’ve not infrequently written about people who, mistakenly believing the blandishments of alternative medicine practitioners that they could forego all that nasty chemotherapy and radiation and survive their cancer to live a happy, normal life, made the disastrous decision to eschew conventional medical therapy and pursue alternative medicine. My interest in this topic comes from the tendency of both alternative medicine practitioners and the patients themselves whom they’ve treated to tout their still being alive as ironclad proof that whatever quackery that was used works, that it can cure deadly cancers without all those unpleasant side effects and potential complications of our existing “cut, poison, burn” (in the quacks’ words) regimens. Sometimes, however, possibly more frequently than we suspect, such patients come to realize the error of their choices. Indeed, I discussed one such case in detail just last week.

Here, I’ll relate the story of one such young man named Abraham Cherrix, whom I’ve been writing about intermittently since 2006 (yes, since 2006), but hadn’t really thought about for a few years. A week ago, multiple readers sent me a news article about him, and I was very pleasantly surprised, for reasons that you’ll soon see. His story is very instructive.

The “alternative cancer cure testimonial”

Before I delve into Cherrix’s story, it seems appropriate to provide a little background for newcomers. If there’s anything I’ve hoped to convey it’s that these “alternative cancer cure” testimonials are seldom what they seem. Indeed, they’re almost never good evidence that whatever combination of coffee enema and eye of newt (I’m surprised I haven’t heard of eye of newt enemas yet) used by the cancer sufferer was what cured the disease. I don’t have the space (even with my tendency to logorrhea) to go into it in a lot of detail now (read this hoary classic if you want such a discussion), but very often the belief that the alternative cancer cure worked derives from a misunderstanding of the difference between curative chemotherapy used as primary therapy and adjuvant chemotherapy, which is usually administered after surgery in order to decrease the risk of recurrence. Quite often, if you delve into these stories, you’ll find that the patient actually underwent some form of surgical resection of their tumor, as was the case with, for example, Suzanne Somers or Chris Wark. People like this then eschew chemotherapy and proclaim that whatever “natural” treatment they used had cured their disease, even though it was the surgery that cured their disease and all they did by not accepting chemotherapy was to increase their chances of recurrence. (Indeed, when discussing these cases, I frequently use an online tool that estimates, based on clinical trial evidence, by what percentage chemotherapy decreases the chances of recurrence and increases long term survival.) Fortunately, because they survived they’re still around to proclaim themselves as having “naturally” cured their cancers by bucking the medical establishment and those dogmatic poison-pushing thralls of the pharmaceutical industry (as they frequently like to portray oncologists).

There are other reasons why patients with cancer who choose quackery over conventional medicine can appear to be survivors, adding plausibility to claims that they cured themselves, at least to those without training in oncology. They frequently misunderstand the highly variable course of some cancers. In the case of others, like patients treated by Stanslaw Burzynski, there is a small delayed cure rate due to conventional therapy, and the patients and families frequently misattribute the patient’s good fortune to the ineffective treatments the patient underwent after having undergone the definitive treatment. Indeed, in the case of brain tumors, there’s a phenomenon after radiation therapy known as “pseudoprogression,” where inflammation from the radiation causes the tumor to look as though it’s growing on imaging, after which it shrinks and, in a small percentage of cases, disappears entirely. (Guess when the shrinkage occurs. Yes, it often happens while the patient is being treated by Burzynski.) Some cancers have a low (but not so low as to be rare) rate of failing to progress or even spontaneously regressing. Some add less effective conventional medicine modalities to their battery of treatments that kept their disease at bay (which is what Cherrix did, as you will see).

The point is that rarely is there an “alternative cancer cure” testimonial in which the circumstances of treatment allow a cancer physician to attribute the patient’s excellent outcome to whatever alternative medicine was being used or where one can rule out some other cause for why the patient is doing well. Then there’s the whole issue of a form of selection bias. As I like to say, dead patients don’t give testimonials. A corollary to that adage is that alternative medicine mavens don’t like to hear testimonials from patients who tried alternative medicine, found it wasn’t working, and were saved by conventional medicine. As far as alternative cancer cure advocates see it, such patients might not be literally dead, but they are dead to the alternative medicine community, which quickly forgot that these patients had ever been promoted as poster children for cancer quackery.

Abraham Cherrix: The beginning

I first learned of Abraham Cherrix in 2006 through a news story:

NORFOLK – Fifteen-year-old Abraham Starchild Cherrix never intended to challenge the medical establishment when he refused chemotherapy earlier this year.

He simply believed the treatment was poisoning him, rather than saving him from Hodgkin’s disease. What he wanted was a more natural approach, which he sought through an alternative treatment clinic in Tijuana, Mexico.

That decision has led to a courtroom battle, accusations of parental neglect and the possibility of being removed from his Chincoteague home.

A judge earlier this week ordered Abraham to receive diagnostic tests to determine the status of his disease. On Friday, though, the tall, lanky boy refused to abide by the order. After showing up at Children’s Hospital of The King’s Daughters in a crisp white shirt and blue tie, he rejected the test.

“I think my body has taken enough, and it shouldn’t have to take any more,” he said.

Basically, four months before the story quoted above, Cherrix had finished induction chemotherapy for Hodgkin’s lymphoma, a very treatable cancer, particularly in children and teenagers, with a five year survival rate of approximately 85%. Unfortunately, his scans showed that he still had residual tumor, for which the treatment was additional chemotherapy and (possibly) ultimately a bone marrow transplant. It was at this point that he rebelled:

That’s when Abraham dug in his heels. He and his father did some research and decided to try a treatment in Tijuana that includes an organic diet and herbal supplements. Soon after, his case was reported to a child-abuse investigator at the Accomack County Department of Social Services, who asked a judge to order that the teen continue conventional treatment.

Abraham no longer uses the “Starchild” middle name, but, consistent with that name, his family was clearly prone to—shall we say?—alternative thinking. Instead of doing what good parents should do and making sure their son received proper treatment, they sought out “alternatives.” The alternative cancer treatment they picked out was a doozy, too. They decided to follow treatment recommendations from The Association for Research and Enlightenment, which just so happened to be based in Virginia Beach, which was about a two hour drive from the family’s home in Chincoteague. This Association was founded by a psychic healer named Edgar Cayce, who was known for falling into trances and giving readings on topics as varied as Hitler, astrology, the existence of Atlantis, ESP, ancient Egypt, and others. Through Cayce’s Association, Abraham and his father settled on the Hoxsey treatment.

Basically, the Hoxsey treatment consists of herbal concoctions popularized by Harry Hoxsey. Different varieties exist, including an “internal” treatment and external treatments with various pastes made up of some of the components of his treatment (usually used for skin cancers or tumors that can be palpated through the skin). Hoxsey claimed that the formula had been passed down from his grandfather John Hoxsey to his father to him, after his grandfather had mixed together grasses and flowering wild plants growing in a pasture where one of John Hoxsey’s horses grazed daily. The horse supposedly had a cancerous growth that went away, and Hoxsey thought that it was due to the plants upon which the horse grazed. He took plants from the pasture, mixed them together, added some ingredients for home remedies for cancer at the time, and–voilà!–he had what he thought was a cure for cancer. Many decades later, Hoxsey’s grandson described how this remedy supposedly worked thusly:

“It follows that if the constitution of body fluids can be normalized and the original chemical balance in the body restored, the environment again will become unfavorable for the survival and reproduction of these cells, they will cease to multiply and eventually they will die. Then if vital organs have not been too seriously damaged by the malignancy (or by surgery or irradiation) the entire organism will recover normal health.”

He [Hoxsey] also did not claim to know how or why his herbal cancer treatment worked, but he maintained that it “corrects the abnormal blood chemistry and normalizes cell metabolism” by “stimulat[ing] the elimination of toxins which are poisoning the system.”

There’s only one problem. There’s no good evidence that the Hoxsey treatment has any net anticancer activity whatsoever. Although some of the components have been reported to have mild antitumor activity in cell culture and animal systems, others have been reported to promote tumorigenesis. In any case, there is no evidence that the Hoxsey treatment as given has clinical efficacy against any human cancer. Indeed, the NCI investigated Hoxsey’s case series, and, as is frequently the case with such reports, concluded that there was inadequate information recorded to make any conclusions at all. The FDA investigated 400 cases whom Hoxsey claimed to cured and found not a single case of a bona fide cancer cure (Semin Oncol 1979;6(4):526-535). Indeed, in 1956, the FDA Commissioner ordered the posting of a “Public Beware!” warning against the Hoxsey treatment in U.S. Post Offices all over the country. And, as quacks frequently do, Hoxsey went to his grave claiming he was being “persecuted” by the “establishment.”

Until her death in 1999, Hoxsey’s longtime chief nurse Mildred Nelson continued Hoxsey’s legacy and administered his “treatment” in Tijuana, claiming an 80% success rate. Of note, Nelson believed that a “bad attitude” was usually responsible for her “20 percent failure rate” she reported for the Hoxsey treatment, with a patient’s strong belief that the treatment is going to lead to recovery being the best predictor of success. Convenient, isn’t it? Those pesky patients who have the temerity to die in spite of the Hoxsey treatment? Well, it was obviously their own fault! They didn’t believe hard enough!

Not surprisingly, Abraham Cherrix rapidly became a poster child for alternative medicine, with believers in alternative cancer cures castigating the courts for “medical fascism” and “medical kidnapping.” Like the case of Cassandra Callender, which I’ve discussed before, Cherrix was an appealing teen, with a loving family (his father owned a kayak business and his mother homeschooled five children). Unfortunately, even the Cherrixes couldn’t resist joining. His father was quoted at the time:

Jay Cherrix echoed that skepticism. He said that while his family would comply with the order of the court, he has trouble imagining a doctor violating his son’s wishes.

“I personally don’t think there is a Dr. Mengele in the United States who would pump this stuff into a 16-year-old who didn’t want that. I personally don’t think we’ve reached that point in our civilization,” he said.

In the meantime, Cherrix’s tumors continued to grow.

The court battle and aftermath

In July 2006, as discussed by bioethicist Art Caplan, the parents were charged with medical neglect and appeared before the Accomack Juvenile and Domestic Relations Court. The judge ruled that the parents should relinquish custody of Abraham, so that the state could make sure that he was treated with the recommended higher dose chemotherapy and radiation as soon as possible. However, right before the order was to take effect, the family obtained a stay from the Circuit Court of Accomack County and regained full custody, pending a new hearing. On August 16, 2006, Accomack Circuit Court Judge Glen Tyler cleared Abraham’s parents of all charges of medical neglect. He also announced that a settlement had been reached between the family and the Virginia Department of Social Services in which Abraham would be allowed to pursue the Hoxsey treatment as long as he was monitored by a board-certified oncologist in Mississippi with knowledge of alternative cancer treatments. The court stated it would “keep an eye on Abraham” to make sure that his treatment was reasonable.

Here’s the kicker. The doctor in Mississippi chosen by the Cherrixes (agreed to by the court) to oversee Cherrix’s care was not exactly what I’d refer to as a reputable oncologist Yes, 11 years ago, I did a little Googling and made a good guess. It turns out that doctor chosen was a radiation oncologist is: R. Arnold Smith, M.D.. Here is the tale:

Smith’s clinic employs immunotherapy, an innovative treatment that works to restore the immune system that age and cancer break down, helping the body fight back.

Combined with radiation therapy to debulk cancer, molecular targeted therapies to arrest host defenses, genomic assays, and chemotherapy when necessary, immunotherapy helps patients live a higher-quality, longer life, the oncologist says.

Today, after the short hearing, the judge looked at Abraham and said, “God bless you, Mr. Cherrix.”

Dr. Smith offered in his clinic the following treatments:

Dr. Arnold Smith was awarded a method patent for his application of Interleukin 2 to create a factory for natural killer cells. This treatment appears to be a significant innovation and advance. Interleukin 2, when injected subcutaneously, has been known for some time to produce a firm nodule often called an “injection site nodule.” These nodules, we believe, are composed of significant colonies of clonally-replicating natural killer cells.

Additional daily injections of Interleukin 2 are best exploited if they are given by injection just on the periphery of the nodule or plaque. Our current policy is to “grow” the initial nodule by progressive injections until a sizable plaque is created, measuring 8-10 cm in diameter. It becomes slightly inflamed, hot, swollen, sore, and red. The plaques are not very painful, but have occasionally contained areas of skin necrosis which have always healed completely.

It may be that use of Cimetidine, antioxidants, and replacement hormones facilitate the production of these plaques to a significant degree. We have seen several patients with lung cancer and colon cancer who have shown progressive decline in Carcinoembryonic Antigen after Interleukin 2. Belly Plaques were created and sustained.

I looked for articles in the peer-reviewed scientific literature published by Dr. Smith about this technique, but there was nothing in Medline more recent than the 1990s that I could find and none of it was about IL-2. However, Dr. Smith did list a number of publications on his CV on this technique in a journal I’ve never heard of before, Bulletin of Urgent and Recovery Medicine, a website for which I’ve been thus far unable to find. Looking at his CV and publication record, it appears that sometime around 1998 or so his publications stopped being mainstream and moved into this new “immunotherapy” and “anti-aging” medicine.

It is true that IL-2 has been used for melanoma and renal cell carcinoma. It can actually be fairly nasty stuff, with a lot of side effects, including capillary leak syndrome, hypotension, and acidosis. It’s also not all that effective, with perhaps a 20% response rate, but, unfortunately, for refractory tumors like melanoma and renal cell carcinoma, it and interferon are about the best we have. Sadly, no evidence is presented that Dr. Smith’s method does anything other than raise a really nasty looking wheal on the abdomen.

I also found it rather odd at the time that Abraham picked a therapy that is guaranteed to result in large painful welts on his abdomen using a cytokine that is not without side effects, all because he’s so adamant that he doesn’t want to suffer the side effects of chemotherapy again, but I’ve given up trying to understand his thought processes. At the time, I guessed that the settlement was about the best that could be hoped for, given Abraham’s age and tenacity. Basically, Dr. Smith let Cherrix go to the Tijuana clinic to receive the Hoxsey treatment and apparently treated him with his own special brand of “immunotherapy.”

Not surprisingly, less than a year later, these treatments didn’t stop his cancer. By January 2007, Cherrix was undergoing radiation therapy to shrink enlarged lymph nodes under his arms. By June 2007, he had relapsed again with a lesion on his lung. As I said at the time, treating this local tumor on the lung was very unlikely to cure Abraham’s cancer, because the cancer would just pop up somewhere else in his body. Dr. Smith and Abraham were in essence playing a game of Whac-A-Mole with his cancer. It turns out that this could (and did) go on for quite a while. It also turns out that without systemic therapy (i.e., chemotherapy) to kill the microscopic deposits of tumor that are responsible for new tumors popping up, the tumor would never be eradicated. I turned out to be correct, but that’s no big achievement. After all, I had a real oncologist (Dr. Craig Hildreth) to explain to me why what I thought was the case was actually the case and, more importantly, why zapping lymphoma tumors with radiation as they pop up is a strategy doomed to fail, referring to such a treatment as the “fallacy of moderation,” and concluding:

Thus, my final opinion: Abraham Cherrix should consider high-dose chemotherapy with stem cell support if he wants to cure his Hodgkin lymphoma. However, even this ultra-therapy has no guarantee of success, especially if one factors in his lung disease and his short duration of response to initial therapy.

Dr. Hildreth was correct, as you will now see.

Abraham Cherrix smolders along

Amazingly, Cherrix did fairly well for several years. He turned 18 in 2008 and seemed to be doing well. (Unfortunately, he was also giving talks at medical schools promoting pseudoscience and quackery using himself as a testimonial. Indeed, as I went back through old posts elsewhere while researching this post, I marveled that the last time I had written about him, other than in passing, was in 2013. Unfortunately, Cherrix was not doing that well. Indeed, he had a GoFundMe page asking for money for treatment:

Despite keeping positive and fighting for my life, I find myself in the same position yet again. I learned today that the cancer has returned to my left lung, explaining a long series of events leading up to it (coughing up blood, shortness of breath, difficulty sleeping, chest pains etc). Now that it’s more aggressive than before, I don’t feel like I have much time. I need to act fast and I’m limited with what I can do.

I have some treatment options that I could pursue and things I could do to improve my condition or even help cure me, but they’re expensive and not covered by my medical insurance (Medicaid/Medicare). I need supplements to boost my immune system, while seeking out doctors country-wide for different treatments and opinions. I need better food that I can’t afford, and I want to move out of my trailer and into a clean house. Most of these costs [sic] thousands of dollars alone… and I’m barely able to afford a ride into town for grocery supplies.

There are actually a few specific treatments I’d love to start with. Heated needle therapy is a good start, and something I’ve been curious about. Studies now are also showing the validity of Hemp Oil as a cure for cancer, so I’m trying to get into one of the research groups. However if I can’t get into these groups, the expense will be monumental and certainly not covered by my insurance.

After that, I hadn’t heard much of anything about Cherrix. I had no idea if he was still alive; that is, until last week.

Abraham Cherrix: Alive and well at 27, thanks to real medicine

The article several people sent to me was published on July 27 in the Virginia Pilot. After a recap of Cherrix’s 2006 court fight, we learn:

A lot has happened in the decade since then.

Cherrix, now 27, ended up accepting chemotherapy and also a stem cell transplant last year at the University of Virginia Cancer Center because tumors kept resurfacing.

“Honestly, if I had not done this, I would have died,” Cherrix said in a telephone interview.

Cherrix, who now lives in the southwestern Virginia town of Floyd, said he’s matured and feels humbled in his recognition of the value of scientifically based treatments.

“The other treatments didn’t have any hard evidence behind them,” he said. “There was no concrete evidence. I know what I am doing now is founded in reality, and I know it’s the best choice for me, and it’s scientifically based.”

Another rather odd thing we learn from the article is Dr. R. Arnold Smith, who treated Cherrix as part of the court agreement, was indicted in 2012:

Smith was charged with capital murder and conspiracy to commit murder in a murder-for-hire case that targeted a lawyer who represented Smith’s former wife in the couple’s divorce. Smith was found mentally unfit to stand trial and was committed to a state mental hospital in 2014. He was later released to private mental health treatment.

I didn’t learn anything in the article that I didn’t know, at least not up until 2013. So what most interested me was what brought Cherrix to the realization that he had to abandon the quackery and undergo real medical treatment if he wanted to have any hope of survival. The answer was there. He kept relapsing and undergoing radiation treatment. As predicted, eventually tumors started returning in areas that had been radiated before, meaning that he couldn’t receive radiation there again because radiation doses are cumulative over a person’s lifetime and the tissue damage they cause permanent. So by 2015, this was his situation. His parents had divorced, and he moved back in with his mother. Then:

In 2015, Cherrix hit a low point. He felt so tired, he was sleeping most of the day, he lost his appetite and began losing weight. A half a sandwich a day was all he could muster. His hair thinned and he felt feverish. He was also coughing up blood, and his back hurt. He went to oncologist Robert Rotche in Blacksburg, who ordered a biopsy and scans that showed a tumor pressing against his backbone.

The doctor began treatment with an antibody drug called brentuximab vedotin, which is used to treat relapsed Hodgkin’s. The medication reduced the tumors and symptoms and improved his blood counts. Rotche also referred him to the cancer center at the University of Virginia Health System in Charlottesville for a stem cell transplant.

In 2016, Cherrix underwent an autologous stem cell transplant. Before undergoing high dose chemotherapy and radiation, his stem cells had been harvested and stored, and they were reinfused on August 4, 2016. So far Cherrix has done well and is now taking brentuximab vedotin, which selectively targets tumor cells expressing the CD30 antigen, a defining marker of Hodgkin lymphoma, as consolidation therapy, and has been shown to improve survival.

Cherrix’s oncologist, naturally, is a bit vague on whether all the delay in treatment compromised Cherrix’s chances of survival. I have no doubt that these delays did, because they delayed his definitive treatment. Clearly Cherrix was very lucky, though. He had disease indolent enough that it did not “break out” and kill him, even during ten years of inadequate treatment with “pinpoint” radiation. Basically, it grew slowly enough and locally enough to allow his life to have been prolonged by nearly a decade using local therapy alone. I remain amazed (and happy) that his disease never blossomed all over his body during that time. If it had, all the “pinpoint” radiation in the world, “complemented” with bogus immunotherapy and the quackery known as Hoxsey therapy, wouldn’t have saved him. I’m just very happy that Cherrix’s disease was slow-growing enough that he lived long enough to come to realize what a disastrous decision he had made 11 years ago. I also realize that he’s not out of the woods yet, as his oncologist explains in the article that he’s got to hit the three year mark before he can be considered to be, in essence cured (or at least to have a very high chance of remaining cancer-free). I hope he makes it.

He hasn’t entirely disavowed his original decision, though:

Cherrix, while supporting evidence-based measures, said he still stands by his original stance of researching the treatment. His advice? “Question the world and how it works, but also be sensible.”

Which is not unreasonable, but I’d add to that: It’s good to be open-minded, but don’t be so open-minded that your brains fall out. Hoxsey therapy is one of those alternative medicine treatments that’s so obviously bogus that putting your life in the hands of a quack in a clinic in Tijuana administering that treatment falls under the category of being too open-minded.

Abraham Cherrix’s legacy

It’s not surprising that, once it became clear that Cherrix’s cancer wasn’t going away for very long, news of him in the sorts of websites and discussion boards where believers in alternative medicine tout the latest “miracle” cancer cures rapidly faded to nothing. Nor is it surprising that Cherrix is now a human interest “Where are they now?”-sort of story in a local newspaper. It’s true that one part of Cherrix’s legacy will be that, after a long flirtation with alternative medicine to treat his cancer, he finally came around to science and thus very likely saved his life. Unfortunately, that is not his only legacy. He left another, far more harmful, legacy:

Cherrix’s court case resulted in a Virginia law – known as Abraham’s law – that gives teenagers 14 or older and their parents the right to refuse medical treatments for ailments such as cancer. Teenagers and their parents can seek alternative treatments so long as they have considered all other medical options.

When I first heard about the law back in 2006, I thought of it as somewhat disturbing but probably another example of “placebo legislation,” a law that makes those passing it feel good but does little or nothing. In cases of a terminally ill child being treated with alternative medicine, the courts would still have had to examine the case and rule on whether or not the treatment, assuming it was carried out in what the parents believed to be the child’s best interest, constituted medical neglect. Also, in its original form, Abraham’s Law would have applied only to children with “terminal illnesses.” By the time it was passed and signed into law by the governor, the bill had broadened its reach to children with “life-threatening” condition and changes the definition of an “abused or neglected child” as follows:

Definition of abused or neglected child. Specifies that a decision by parents or another person with legal authority over a child to refuse a particular medical treatment for a child with a life-threatening condition shall not be deemed a refusal to provide necessary care if (i) such decision is made jointly by the parents or other person with legal authority for the child, and the child; (ii) the child has reached 14 years of age and is sufficiently mature to have an informed opinion on the subject of his medical treatment; (iii) the parents or other person with legal authority, and the child have considered alternative treatment options; and (iv) the parents or other person with legal authority, and the child believe in good faith that such decision is in the child’s best interest. Stipulates that this test shall not be construed to limit the provisions of §16.1-278.4 on children in need of services.

Worse, Virginia law now lists as an exclusion in the definition of an abused or neglected child:

However, no child who in good faith is under treatment solely by spiritual means through prayer in accordance with the tenets and practices of a recognized church or religious denomination shall for that reason alone be considered to be an abused or neglected child.

Basically, as a result of Abraham Cherrix’s battle, if you’re a child between the ages of 14-18, the State of Virginia no longer protects you from quackery or religious idiocy. Worse, it’s not just limited to children with “terminal” illnesses, where, it can be argued, nothing can save them and taking them away from their parents to have them obtain conventional therapy would cause them undue stress in the precious few remaining weeks or months of their lives. The law includes any child with a life-threatening condition. In other words, it now applies to all children in the State of Virginia with cancer, no matter how treatable the cancer is, because cancer is certainly a life-threatening condition.

Consider the practical import of this bill. Let’s say a 14-year-old is diagnosed with leukemia. Let’s further add that it’s an eminently treatable form of leukemia, with an expected remission and long term survival rate of over 90%, with the proper chemotherapy and targeted therapies which, thanks to science-based medicine, is not uncommon in pediatric cancers. Now, I’m not a lawyer, but under this law, it appears that parents can choose any quackery they wanted, be it the Hoxsey therapy, urine therapy, homeopathy, or whatever, as long as the decision to pursue this quackery was made “jointly with the child.” Now consider this: For a 14-year-old (or even for a 16-year-old or 17-year-old) living with his or her parents, how difficult do you think that it would be for the parents to get the child to agree with them, particularly if, as most believers in alternative cancer cures would do, they frame it as a choice between the horrors of chemotherapy (and, in the case of other tumors, surgery and radiation) versus a “natural” alternative that won’t cause them any pain or symptoms at all? Yes, saying it’s not neglect to use quackery to treat cancer in a child as long as the child agrees to it is the height of disingenuousness, and passing a law that codifies that statement is the height of irresponsibility.

But it’s worse than that.

Consider the case of a 14- to 17-year-old whose parents are Christian Scientists or other religions that claim that prayer alone can cure disease. Naturally, in the vast majority of cases, the child will have been raised in the same religion and will believe in its tenets, as his parents do. If that child gets cancer, it’s pretty likely that he would agree with his parents that prayer and whatever rituals demanded by the religion would be the proper treatment for the cancer and thus would agree with whatever woo the religion prescribes for treatment. As I like to say in cases like this, I support the right of any competent adult to choose whatever therapy for himself that he chooses—or no therapy at all. But children are different, even teenagers. We can argue about at what age a teen is competent to make life-or-death decisions like whether or not to take chemotherapy for a life-threatening cancer, and I did discuss my views on this topic while covering the case of Cassandra Callender, but clearly 14 years old is too young. So is 15.

Make no mistake. I’m very, very happy that I was so amazingly mistaken when I declared after the court ruling letting Cherrix pursue Hoxsey treatment and Dr. Smith’s bizarre combination of inadequate radiation therapy and bogus immunotherapy. However, he and his family served as the impetus for a law that basically eliminated the ability of its child welfare services to intervene in the case of 14- to 17-year-olds whose parents decide to pursue woo instead of effective medical treatment, not just for children with terminal illnesses, but for any child in that age range with a serious, life-threatening condition.

Unfortunately, that’s part of his legacy as well.

By Orac

Orac is the nom de blog of a humble surgeon/scientist who has an ego just big enough to delude himself that someone, somewhere might actually give a rodent's posterior about his copious verbal meanderings, but just barely small enough to admit to himself that few probably will. That surgeon is otherwise known as David Gorski.

That this particular surgeon has chosen his nom de blog based on a rather cranky and arrogant computer shaped like a clear box of blinking lights that he originally encountered when he became a fan of a 35 year old British SF television show whose special effects were renowned for their BBC/Doctor Who-style low budget look, but whose stories nonetheless resulted in some of the best, most innovative science fiction ever televised, should tell you nearly all that you need to know about Orac. (That, and the length of the preceding sentence.)

DISCLAIMER:: The various written meanderings here are the opinions of Orac and Orac alone, written on his own time. They should never be construed as representing the opinions of any other person or entity, especially Orac's cancer center, department of surgery, medical school, or university. Also note that Orac is nonpartisan; he is more than willing to criticize the statements of anyone, regardless of of political leanings, if that anyone advocates pseudoscience or quackery. Finally, medical commentary is not to be construed in any way as medical advice.

To contact Orac: [email protected]

13 replies on “Following up on a very old case: Abraham Cherrix is alive and well because he finally rejected alternative medicine”

It is unfortunate that his case encouraged others to reject conventional treatment – and his original story is still being circulated as a reason to reject Chemo…..

But, thank goodness the man got real treatment. This is another example of how much better Cancer treatments and survival rates have gotten – it isn’t perfect, but if someone like this can be helped, certainly does better the odds for someone who starts down the right path from the beginning.

Ten years is a long time to allow others to believe the quackery was working. That could be quite a trail of tears and loss.

…since 2006 (yes, since 2006)…

Goodness, how time flies. This is the story that introduced me to RI. Starchild is, more or less, a local boy, and looking for a bit more information led me here.

I’ve learned a bit over the years, and had more than a few laughs. Thanks for keeping on keeping on.

I now return you to more on topic posts.

However, no child who in good faith is under treatment solely by spiritual means through prayer in accordance with the tenets and practices of a recognized church or religious denomination shall for that reason alone be considered to be an abused or neglected child.

Two immediate thoughts:

– forget cancer. Let’s pick diabetes (type 1), or even more simply meningitis. Following this law, parents can try to pray away the illness, and no-one can interfere, even if the child dies?
Or am I reading too much into this?

– I hope they define somewhere “recognized church(es) or religious denomination(s)”. Depending on who you ask, the list could be very long or very, very short.

– I hope they define somewhere “recognized church(es) or religious denomination(s)”.

Another piece of vague law making – “…the child has reached 14 years of age and is sufficiently mature to have an informed opinion on the subject of his medical treatment.”

But I’ve always felt that most of the blame in all this belongs with the parents. If they had told the kid ‘shut up, and take your medicine’, we wouldn’t have any of this mess. But like too many parents I’ve seen, they wanted to be friends first and parents second. There’s time to do that once the kids grow up (and is mostly necessary once they are adults), but while they are still in high school is too early.

This is slightly off-topic, but I thought I’d note that this sentence:”It’s also not all that effective, with perhaps a 20% response rate, but, unfortunately, for refractory tumors like melanoma and renal cell carcinoma, it (IL-2) and interferon are about the best we have.” is no longer accurate.

Immune checkpoint inhibitors (e.g., nivolumab and pembrolizumab) are much more effective than IL-2 for the treatment of metastatic melanoma. The ORR for metastatic melanoma patients treated with a combination of nivolumab and ipilimumab is 57%, and some of the responses to immune checkpoint inhibitors are complete and durable.

In fact, even in patients treated with ipilimumab monotherapy (which is significantly less effective than combination treatment with ipilimumab and a anti-PD1 monoclonal antibody like nivolumab or pembrolizumab, or monotherapy with an anti-PD1 monoclonal antibody), the 7-year survival rate was 34%, with the survival curve leveling off at around that point, indicating that most of the patients who were alive at 7 years were probably cured of their disease.

And, like I said, nivolumab and pembrolizumab are even more effective than ipilimumab is, for the treatment of metastatic melanoma (and for quite a few other forms of cancer as well, including many that were previously thought to be unlikely to respond to immunotherapy), and the 5 year survival rate for metastatic melanoma patients treated with nivolumab was reported to be 34%.

Plus we have “targeted” drugs like vemurafenib, and the combination of dabrafenib and trametinib, that are effective in the treatment of BRAF V600E mutation-postivie metastatic melanoma (although these drugs tends not to produce the kinds of durable responses that the immune checkpoint inhibitors can).

So I guess my point is just that there are now a number of different treatment options for metastatic melanoma that are much more effective than (and better tolerated than) IL-2. Same is true for patients with metastatic RCC.

I’m so glad to hear he’s doing well.

A few years a go I interacted with him right here at RI and I thought him a lovely person.

From the photo, looks like he has had quite a bit of muscle wasting from mantle radiation. I wonder how much he might have avoided with proper up-front treatment.

However, he and his family served as the impetus for a law that basically eliminated the ability of its child welfare services to intervene in the case of 14- to 17-year-olds whose parents decide to pursue woo instead of effective medical treatment…

What if you have only homicidal oncologists in your area? Like Dr. Fata?

What would you recommend when a patient is restricted geographically to a locus of kill-for-profit physicians (like Detroit)?

There needs to be a big solid mainstream documentary made and put out there about these cases, including Jess and Sharyn Ainscough, Polly Noble stories, as well as Cherrix, Carissa Gleason, and all who turn back to mainstream treatments after they realise they’ve been catastrophically mislead by alt med.

I’m always on the lookout for new and interesting herbs (medicinal and culinary) so it was a pleasure today to find a plant I’d never seen before, Hoan Ngoc (Pseuderanthemum palatiferum). It definitely is a good-for-whatever-ails-you herb, as one vendor promises:

“Recommended the amount of consumption by 35 Congress of Science and Technology, Thailand, that this medicinal herb can help in respect of the following diseases when consuming for a period of times:-

Hemorrhoids (7-9 leaves/meal)
Dyspepsia (7-9 leaves/meal)
Diarrhea (7-9 leaves/meal)
Chronic Constipation (7 leaves/meal)
Inflammation of stomach/ intestines (9 leaves/meal)
Skin disease (itchy skin & allergy) (2 leaves/meal, 20 leaves/ meal if chronic condition)
Cancer – Lymph cancer (10-20 leaves/meal)
Diabetes (7-9 leaves/meal – sugar decrease may result)
High blood pressure (10 leaves/meal – sugar decrease may result)
Heart disease (4-10 leaves/meal)
Migraine headache (7-10 leaves/meal)
Rheumatoid (7 leaves/meal)
Inflammation of liver (7 leaves/meal)
Blood vessel disease (7 leaves/meal)
Uterus pain (7 leaves/meal)
Muscle pain (7-9 leaves/meal)
Blood urine (7-9 leaves/meal)
Drunk (7-9 leaves/meal)
Pink eyes (10 leaves/meal)
Inflammation of kidney (7-9 leaves/meal)
Nourish bodies (4-9 leaves/meal – strengthen body, not easily tired).”

The plant label also recommends Hoan Ngoc for liver detox and relieving the deleterious effects of chemotherapy and radiation.

Obviously, this is a remedy Orac can’t do without, though it isn’t cheap (300 fresh leaves are going for $75 online). I can beat that price once I get propagation going under lights, so in just a few months I should have all that Orac needs for his patients (better act fast, Cleveland Clinic is also interested).

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