Cancer Decisions: What To Do Post-Diagnosis
Cancer statistics these days are staggering: It is said that 1 out of every 2 men, and 1 out of every 3 women will get cancer in the course of their lifetime. And it seems like more people are getting sick younger. Considering the fact that it seems inevitable, we wanted to understand exactly where you should turn post-diagnosis. And fingers kept pointing to Dr. Ralph Moss of Cancer Decisions, who has been covering both conventional and alternative cancer therapies for more than four decades. He publishes comprehensive reports, which explore a spectrum of treatments from across the globe that show promising, and where possible, clinically-proven results. Because of the landscape of clinical trials in the United States—which aren’t an option for a vast majority of cancer patients—access to many of these alternatives can be found abroad. Below, he explains a bit more.
A Q&A with Dr. Ralph Moss
Do you not take funding because you want to be able to offer unbiased advice?
Correct. I don’t take funding because I believe it’s a conflict of interest. Let’s put it this way: I never figured out how I could be funded by anybody with a vested interest in the cancer field and be serving my clients 100%.
Without trying to be critical of anyone else and how they manage their affairs, a lot of the things you read are actually influenced by the economic interest of somebody. We are not. And also, we don’t sell anything other than our writing. If I’m talking about something as beneficial, I’m not on the other hand, offering to sell it to you. I recognize the fact that you have to have companies, and companies have to make a profit, so I’m not being critical of other people, it’s just that for us, it would seem to dilute our mission and our message if I was talking about CoQ10, and simultaneously trying to sell you a bottle of CoQ10. If we began to make a lot of money from a product, it would be more difficult for me to report anything negative about that product or be less enthusiastic about its effectiveness.
Do you still do personalized consultations?
Yes. The reports are still not specific enough for everyone, because everybody’s case is different. Just because you’re writing about one type of cancer, it doesn’t always address that particular person’s needs and questions.
And so very early on, starting in 1993, I began offering personal consultations to cancer patients. These are generally an hour in length—sometimes it requires less time than that.
What about more rare cancers? Are you ever stumped?
I used to offer over 100 different reports—in fact, at one time, maybe 10-15 years ago, we were sort of the go-to source for rare cancers because we had a policy that we would write a report regardless of how rare the cancer was. But there being only so many hours in a day, if I were to do a super-good job in terms of keeping the major cancers updated, there just wasn’t enough time to update those reports. So we had a lot of reports on rare cancers, but I had to give that up a few years ago in order to maintain the 25 or so reports that cover the vast majority of cancers. I can still do research on rare cancers, but that isn’t the bulk of consultations. The bulk of consultations are for more common cancers, and specifically situations that people find themselves in that are unique to them, or that can’t be addressed in any detail in a written report. I also get a lot of questions relating to where to go for treatment and what would be the best treatment. That’s something that I’ve really been able to do more intensively than anyone in the world.
It seems from your reports that you believe in combining conventional and alternative treatments—is that a fair assessment?
Correct. I think that people get the best results when they use a combination of conventional and complementary treatments. I’m not a big fan of purely alternative treatments. This was very hard for me to accept, to be honest, because I guess, when I was much younger and starting out, I did have the feeling that there were effective alternative treatments. But, I’ve seen too many people go down the tubes who just put all their faith in one or the other. My feeling now is that you have to remove as much of the cancer as possible before you can begin an effective immune treatment. To think you’re going to do it all alternatively just doesn’t work in cancer.
“I think that people get the best results when they use a combination of conventional and complementary treatments.”
In other diseases, I believe it does—I believe that a lot of diseases like type 2 diabetes for instance can really be effectively reversed through natural methods. So I’m not against the concept of using dietary controls because I’ve seen it work, and I know from my reading, that it works beautifully in other diseases. But with cancer…cancer is different. And cancer is more difficult than a lot of the other health challenges people face. We’re in difficult situation: Patients must navigate through a complicated conventional medical establishment, which isn’t always sympathetic toward their general health; meanwhile, the alternative community is more or less cut-off from the conventional, as they’re not accepted, and the interests and concerns of the alternative community are quite different than those of the conventional medicine. It’s hard to bring all of these things together to create a program that utilizes the best of both worlds. I’d like to see them all under one big tent. That would be my dream. And in some instances you do see that happening. But by and large, if you want that sort of integrated approach, you have to go abroad.
How do you know where to send people?
I have made 17 separate trips to Germany to visit separate clinics. That’s just one country. I’ve visited dozens of countries. I don’t think anyone else has done that, not to my knowledge, at least.
For about 9 years, I was an advisor to the National Institute of Health, in what was then The Office of Alternative Medicine, which then became The National Center for Complementary and Alternative Medicine. And I was involved in some of the early evaluations of clinics, but essentially, that evaluation stopped at the American borders. For various legal reasons, which are hard to understand, American investigators couldn’t really go to Mexico, or Germany, or China, or other countries to look at their clinics. First of all there was another office at the NIH that was responsible for international liaisons and affairs, and secondly, it was seen as an endorsement of these clinics to go to them. I never agreed with that, but I saw that the federal government really wasn’t going to be able to do this job. And in fact, to my knowledge, in the intervening 15 years, they maybe went once or twice from the National Cancer Institute to alternative clinics, but that’s all. I can get on a plane and go and visit whomever I want, so it really was a situation that called out for private individuals to do. And I’ve done that.
What is your relationship like with these clinics?
Amazingly, we’ve been able to maintain what I call an atmosphere of friendly skepticism. I maintain my common sense about the clinics and I’m skeptical to the degree that I think we must be concerning all claims made about beneficial effects of treatments. But it’s a friendly skepticism. I try not to fall into the black and white mentality of some of the professional skeptics who are intent on tearing down new treatments without really giving them a fair evaluation or at least the benefit of the doubt in terms of the motivation of the people who are opening and running these clinics. I managed over the years to keep friendly relationships with most of the clinics without necessarily endorsing everything that they do. And that’s hard. You tend to either get too chummy with them, which can lead to a lack of objectivity or else you can offend them and take a superior attitude, or do other things that could be culturally insensitive. In that case you lose your access so you don’t really know what’s going on. A lot of the people who write about this field claim things that don’t correspond with what I’ve experienced and what I’ve learned by actually going out there into the field to the clinics, meeting the doctors, meeting the staff, both positively and negatively. Most of what I read about these clinics doesn’t seem truthful or realistic to me, because I don’t think it’s based on any deep knowledge. It’s hard to come by and expensive to do—some of the people who have written about the German clinics, for example, have based it on one whirlwind trip. How much can you learn in a situation like that? To really understand it, you have to go into depth with what they’re doing and be in touch with them.
Are they doing some of the more interesting work in Germany?
Yes, Germany and the German-speaking countries are really the epicenter of complementary treatment of cancer.
There are about 125 clinics in Germany doing complementary medicine and the whole scene and culture in Germany is very predisposed to be positive to this type of treatment. The idea of complementary treatment is very popular in Germany, even in the medical community. It’s very rare to run into a doctor in Germany who isn’t very familiar with, and somewhat sympathetic to complementary medicine—a lot of doctors practice one form or another of complementary medicine.
Now, because of the work the NIH has done in this field over the past 20-odd years, these types of treatments are becoming slightly more popular in the US. Though most doctors, particularly older doctors, are pretty unfamiliar and unconvinced.
What are you seeing that’s very promising?
Because these are basically private clinics, both in-patient and out-patient, they have an enormous degree of latitude and variety in terms of what they can do. But if you were to summarize the core program in Germany in terms of complementary approaches to cancer—in other words, approaches other than just doing chemo, radiation, and surgery—it’s basically immunological in nature.
For a long time, since the 1960’s, the German’s have been using immune-modulating or immune-stimulating substances, the most famous of which is Mistletoe. Mistletoe was approved by the German government in 1963 for the treatment of advanced breast cancer and is now very widely used in Germany as a way of boosting the immune system, like after surgery to bring the patient’s immune system back to normal and to help them fight the cancer.
“If you were to summarize the core program in Germany in terms of complementary approaches to cancer—in other words, approaches other than just doing chemo, radiation, and surgery—it’s basically immunological in nature.”
There are four companies in Germany that produce medicinal mistletoe and sometimes it gets very involved, too complicated to discuss in this conversation, but these are large companies. In fact, the cosmetics company, Weleda, is actually at its roots, a company that produces mistletoe for cancer patients. You pay a little bit more for Weleda products—they happen to be excellent products—because the customer is subsidizing keeping the cost of the mistletoe low enough that most people can afford it. So there’s actually a reason why Weleda exists that’s different than most companies that are set up to make a quick buck. The mistletoe is fermented, there’s a big lab in Switzerland that produces it—it’s quite interesting how this all came about. But regardless, that was the first wide-scale immune therapy for cancer in the world.
You also have clinics in Germany that are devoted to producing and using vaccines in cancer—way before this idea became common in research circles in the United States. You have the ability, in Germany, to go to a clinic—many in beautiful facilities in spa towns—where, most likely, they will accept you as a patient. They are certainly familiar with taking people regardless of the stage of their cancer. And they can treat people with vaccines of various kinds. It could be a vaccine made from the patient’s own tumor. It could be a vaccine of the type of cancer that they have without having to access that person’s individual cancer. Sometimes they use a kind of virus that has anti-cancer abilities, like, for instance, Newcastle Disease Virus Vaccine is available in at least four clinics in Germany that I’m aware of.
“You can’t just walk into a hospital in the United States and say: Give me your viral therapy. You have to fit into the clinical trial protocol.”
Viral therapy is under research in the Mayo Clinic—we have some experimental vaccines that utilize measles against cancer. But you can’t just walk into a hospital in the United States and say: Give me your viral therapy. You have to fit into the clinical trial protocol. And every clinical trial has a lot of inclusion criteria and exclusion criteria—it’s like fitting a key in a lock. Or your characteristics—the stage of your disease, the degree to which it’s been treated, your age, your sex, the presence or absence of other disease states—all that has to line up in order to be accepted into a clinical trial. So as a result only 3-5% of cancer patients ever go into clinical trials. In abstract, they sound like a good idea, in practice most people get turned down, and then can be randomized to not receive the treatment in question. So you go through all of this, and at the end of the day, you find out that you never got the vaccine in question—you got a placebo. This happens fairly commonly.
Ultimately, the clinical trial system doesn’t really offer a good deal to the American cancer patient. Naturally, people are looking for a situation where they can be treated with the treatment that they want—that’s only human. They want to save their life, and who can blame them? The clinical trial system is set up to serve the interests of science with a capital “S”—in other words you’re told going into the trial that what you’re doing is for the benefit of other people, not for yourself. Most people don’t realize that. They’re understandably trying to get something for themselves, but they’re being told, no, you must sacrifice yourself for future generations—not too many people want to do that. So that creates an opening for other clinics that will treat people with experimental methods that are not part of the clinical trial system.
So are these things effective? Do they have a lot of merit?
Again, it’s hard to know—because this is the paradox. The way we know a treatment is truly effective, or how effective it is, let’s say, is through clinical trials. But on the other hand a lot of things happen in medicine without clinical trials because it just seems obvious that they are likely to be beneficial. And you can show within the context of a particular institution that they’re getting good results. I could say, for instance, that proton beam therapy, which is one of the most exciting forms of radiation therapy, is incredibly effective—there’s never been a clinical trial to demonstrate its superiority to standard radiation therapy. It’s just that it does what radiation therapy does more accurately and more effectively, so it’s allowed—there are 15 centers or so doing this in the United States. Many other things are like that, including drugs that have been approved without randomized clinical trials—ultimately, the FDA agrees that rigorous clinical trials aren’t always necessary before you introduce a new treatment.
“Proton beam therapy, which is one of the most exciting forms of radiation therapy, is incredibly effective—there’s never been a clinical trial to demonstrate its superiority to standard radiation therapy. It’s just that it does what radiation therapy does more accurately and more effectively, so it’s allowed.”
It’s the same thing with immune therapy—there’s a lot of evidence for its effectiveness, including anecdotes, case series, some clinical trials, some retrospective reviews. But if you wanted to truly get in front of Congress and state that this is an effective treatment you’d need to do the randomized trials which cost millions of dollars and take many years. It’s hard to achieve that level of proof—there’s a lot of other evidence that it is effective.
In the case of heat therapy—hyperthermia—we do have clinical trial data to show that it is an effective added treatment to other treatments. Ethically this is considered the only kind of trial that can be done. When you add a complementary treatment to another effective treatment because otherwise you’d be denying patients the conventional treatment, which is a no-no around the world.
But when we add heat treatment to radiation therapy or chemotherapy—the experience so far has been that it improves the results of those conventional treatments. That’s been shown in both Holland and in Germany in a series of very good clinical trials in cervical cancer, in sarcoma, in one other type of cancer, and in many other phase 2 trials. Hyperthermia could be effective for a number of reasons. But one of the main reasons is that you’re generating a kind of immune system effect.
So this is not generally available in the U.S.?
Correct. Your chances of getting it in the U.S. are very limited, and when it comes to whole body heat therapy, it’s almost non-existent in the United States.
What about electricity as a form of treatment?
There have been a number of electrical treatments for cancer, and more recently, the FDA, which had always been against these electrical treatments, has approved a treatment for some brain cancers that’s been very effective—and it’s nothing more really than electricity from a continuous nine-volt battery. It’s not painful for the patient. In short, if you run an electrical current through the tumor, you disrupt the ability of the cancer cell to reproduce. That concept, which has been kicking around for more than 100 years, has gotten limited FDA approval. It’s a device that actually came from Israel from the Technion in Haifa, and now it’s somewhat available. There is something to the idea of using electricity—it’s one of the unrecognized and underutilized types of treatments.
Do you believe there’s a connection between diet and cancer?
I would say this: One thing that’s been a surprise for me in the past few years is how parallel the problem of type 2 diabetes and the problem of cancer are. I would think that when people start to think about changing their diets, they should also realize that the measure of how successful and how healthy your metabolism is lies in the blood/sugar picture. And cancer is a disease that’s notorious for its over-consumption of glucose. By the way, according to the last numbers I saw, ½ the adult population is pre-diabetic or diabetic—and many cancer patients are in that category. When you allow your blood sugar to fluctuate wildly—or you live in a state of pre-diabetes or outright diabetes, whether you know it or not—then you can’t just adopt dietary changes that are going to increase, not decrease the problem of sugar metabolism. Most cancer patients know that they need to cut out sugar. But what is sugar? Grains can turn into glucose. Fruit juice, and carrot juice even, is notorious for quickly turning into glucose and spiking blood pressure. You have to think carefully about how you’re going to eat if you do make changes to the standard American diet because not everything being advocated out there is based on sound knowledge of what food does to metabolism. That’s been a big revelation to me.
“There is new research at Purdue University that green tea is a much more powerful anti-cancer agent then people have given it credit for.”
Another thing I think people should look at it is green tea. Because there is new research at Purdue University that green tea is a much more powerful anti-cancer agent then people have given it credit for. Because of the target molecule that green tea primarily affects, it’s very helpful to have a small amount of red pepper in your system at the same time. And green tea can be taken in a supplement form. That supplement is a concentrate of the catechins, or the chemicals that exist normally in the tea. It’s a concentrated form of the tea with a small amount of red pepper added—and that blocks the unique chemical that allows the cancer cell to grow to normal size. If a cancer cell can’t grow to a normal size after it’s divided, then it will self-destruct within 3-4 days in a process called program cell death. It self-destructs because it’s unable to divide, and it’s too small to divide. That’s a trigger that every one of our cells has—some people call it apoptosis or program cell death. That’s the most favorable mechanism by which most cancer cells die. You can do this with green tea and red pepper. You need to take it continuously, in other words, every four hours, if a person wants to do reverse an early stage cancer. This is the kind of stuff that we talk about in my reports.
This has been very widely researched, and there’s an amazing body of work that’s gone almost unrecognized by the overall cancer community because it was done within the biochemistry community. It happened in a PhD science environment, not in a medical environment, and so it didn’t get a lot of play in the medical community. It’s just beginning to enter the consciousness of the field of oncology. I’ve become very aware of this, and am very interested in bringing this to the public’s attention.
How important is the spiritual and emotional component of dealing with the disease?
I don’t think you can undertake effective cancer treatment without summoning all of your mental and spiritual reserves. It’s a challenge—the fear alone is tremendous—and so if you’re going to go through a difficult treatment, you need a strong support system. To go through it alone with a difficult diagnosis is extremely hard. Many people really can’t do that.
The mental component is enormously important. I wouldn’t go so far as to say though that I have any evidence that cancer is caused by emotional factors. It’s been suspected for 2,000 years that it is—there just hasn’t been a good study that’s demonstrated it. But leaving aside that idea, the mental state does affect hormonal state. Your willingness to comply with a healthy lifestyle, while you’re undergoing treatment could affect your outcome. There are so many factors that are pressuring you to give up. It’s so important that you’re in a place that has a very positive attitude.
“Some of the success of some of the alternative clinics, undoubtedly comes about not because their methodology is so much better—it may be somewhat better—but it’s because they know how to treat people to keep them in a very positive frame of mind.”
It’s kind of like going to college. You have to look at many factors of where you’re going to go to be treated, and it still has to feel right. If it doesn’t feel right, you’re probably in the wrong place. And there are huge differences between medical centers and how they treat people. And some of the success of some of the alternative clinics, undoubtedly comes about not because their methodology is so much better—it may be somewhat better—but it’s because they know how to treat people to keep them in a very positive frame of mind. There is a quote unquote “placebo,” or mind-body aspect of this that isn’t often recognized.
Alternative treatments also give hope—and that’s not a bad thing. It’s sometimes depicted as false hope—but hope, itself, is not a false emotion. Hope is extremely positive.
The medical writer Ralph W. Moss, PhD, has written or edited twelve books and three film documentaries on questions relating to cancer research and treatment. Moss is a graduate of New York University and Stanford University. The former science writer and assistant director of public affairs at Memorial Sloan-Kettering Cancer Center in New York (1974-1977), for the past 40 years Moss has independently evaluated the claims of conventional and non-conventional cancer treatments.
Moss is the long-time “War on Cancer” columnist for the Townsend Letter for Doctors and Patients. His most recent book, Doctored Results, deals with the testing of laetrile at Sloan-Kettering. It covers in detail the same ground as Eric Merola’s 2014 documentary, Second Opinion. He is also the author of Customized Cancer Treatment, Antioxidants Against Cancer, Cancer Therapy, Questioning Chemotherapy, and The Cancer Industry, as well as the award-winning PBS documentary The Cancer War. He wrote the first article on complementary and alternative medicine (CAM) for the Encyclopedia Britannica yearbook and the first article on CAM cancer treatments for a medico-legal textbook, Courtroom Medicine: Cancer. With Prof. Josef Beuth of the University of Cologne, he edited the first medical textbook in English on such treatments, Complementary Oncology (2005).
His articles and scientific communications have appeared in The Lancet, the Journal of the National Cancer Institute, the Journal of Clinical Oncology (2012 & 2013), the Journal of the American Medical Association, New Scientist, Immunobiology, Pharmacological Research, Anticancer Research, Genetic Engineering News, Research in Complementary Medicine, the Journal of Alternative and Complementary Medicine, Journal of Cancer Research and Therapeutics and Integrative Cancer Therapies, of which he is Corresponding Editor. His invited op-ed “Patents Over Patients” appeared in the New York Times.
Moss was a founding advisor to the National Institutes of Health’s Office of Alternative Medicine (now the National Center for Complementary and Alternative Medicine, NCCAM) and to the NIH Cancer Advisory Panel on Complementary and Alternative Medicine (CAP-CAM). He has been a member of the Advisory Editorial Board of the PDQ System of the National Cancer Institute (NCI). He is a board member of the Cancer Prevention Coalition and is an advisor to Breast Cancer Action, Life Extension Foundation, RAND Corporation and the Medline-listed journal, Alternative Therapies in Health and Medicine. He has served as an ad hoc reviewer for numerous scientific publications, including Blood, Current Oncology, Tumor Biology, the Journal of Research in Medical Science, International Journal of Cancer, as well as the Czech Academy of Sciences.
Moss has been an invited lecturer at Memorial Sloan-Kettering Cancer Center (Grand Rounds, Surgery, 1999), Johns Hopkins University School of Medicine, the Aspen Ideas Festival, Howard University Medical School, the University of Arizona Medical Center, the Department of Energy, American Cancer Society, Penn State Hershey Medical Center and many other universities, medical schools and societies in the US and abroad. He led the History of Science Seminar at the National Library of Medicine (NLM) in Bethesda, MD on the life and work of his mentor, the Nobel laureate Albert Szent-Gyorgyi.
He has received lifetime achievement awards from the American College for the Advancement of Medicine, Cancer Control Society, National Foundation for Alternative Medicine, Wellness Forum, and Center for Advancement in Cancer Education.
Moss has a particular interest in fostering international cooperation in integrative oncology. In 1998, he was made an honorary member of the German Society of Oncology (“DGO”), the first American to be so honored. He has toured German clinics on 17 separate occasions. In 2011 and 2012 he co-organized international days for the DGO in Baden-Baden and Munich. He is a board member of the Italian Association for Research in Integrative Oncological Therapy (ARTOI) and gave the Coombs Lecture at Foothills Hospital, Calgary and at the University of Calgary, Canada.
In 2008 he was honored with visiting professorships at the Shanxi Province Anticancer Research Institute, Chang’An Hospital in Xi’an, and Friendship Hospital in Guangzhou, China. In 2013, he gave a keynote address at the International Clinical Hyperthermia Society (ICHS) in Guangzhou, China. He was honored with the Grand Award for Special Contribution to Natural Medicine by the ICHS and was appointed a standing director of the World Federation of Chinese Medicine Societies (WFCMS). He was also honored with a guest professorship at the Southern Medical University (Renkang Hospital) in Dongguan, China (2013-2016).
He has visited Israel in collaboration with Reliable Cancer Therapies (Belgium) and has also made site visits to cancer clinics in Germany, Holland, Austria, Hungary, the Czech Republic, Russia, Switzerland, Denmark, Italy, Bahamas, Honduras, Great Britain, and most states of the US and provinces of Canada.
The views expressed in this article intend to highlight alternative studies and induce conversation. Consult your doctor before making any changes in your medical routine.