The Cancer Cure Anecdote

Dr. Ian Gawler, a veterinarian, suffered from osteogenic sarcoma (a form of bone cancer) of the right leg when he was 24 in 1975. Treatment of the cancer required amputation of the right leg. After completing treatment he was found to have lumps in his groin. His oncologist at the time was confident this was local spread from the original cancer, which is highly aggressive. Gawler later developed lung and other lesions as well, and was given 6 months to live due to his metastatic disease.

Gawler decided to embark on an alternative treatment regimen, involving coffee enemas, a vegetarian diet, and meditation. Eventually he was completely cured of his terminal metastatic cancer. He has since become Australia’s most famous cancer survivor, promoting his alternative approach to cancer treatment, has published five books, and now runs the Gawler Foundation.

At least, that is the story he believes. There is one major problem with this medical tale, however – while the original cancer was confirmed by biopsy, the subsequent lesions were not. His oncologist at the time, Dr. John Doyle, assumed the new lesions were metastatic disease and never performed a biopsy. It was highly probable – the timing and the location of the new lumps following a highly aggressive cancer. But even a diagnosis that is 95% likely will be wrong in 1 patient out of 20 – which means a working physician will have patients with the 5% diagnosis about once a week. The standard of practice today would be to do a biopsy to get tissue confirmation of the diagnosis, and rule out the less likely alternatives.

Recently oncologists Ian E Haines and Ray M Lowenthal published a paper in which they advance a plausible alternative theory to the story Gawler has been telling for 30 years. Another part of Gawler’s history is that, at the same time he was pursuing alternative treatment for his presumed metastatic cancer, he was diagnosed and treated for tuberculosis. He was having night sweats, losing weight, and coughing up blood – all symptoms that can be explained by disseminated TB. Gawler acknowledges that he had TB and was successfully treated for it, but contends that he had cancer and TB. Haines and Lowenthal propose their alternate hypothesis, and point out that all of Gawler’s symptoms (following successful treatment of his sarcoma) could be explained by TB.

Haines and Lowenthal conclude in their paper:

This hypothesis is advanced for two reasons. The first is to underline the modern recognition of the need to consider diagnostic investigations, including biopsy, before assigning the diagnosis of advanced cancer to any patient. This principle is especially vital in cases where two diseases can present in the same way.  The second is that there a risk that if diseases are incorrectly labelled, incorrect treatments may be given. This can lead to misleading interpretations being made about non-traditional treatments providing “cures,” which can influence the decision-making of patients seeking answers and even lead them away from potentially curative traditional treatments.

As oncologists they want to emphasize the point that biopsy is necessary in such cases – that is a fairly accepted position. They go further to point out that incorrect diagnosis is one source of misleading stories that could convince many cancer patients that an ineffective “alternative” treatment is effective, and therefore interfere with their informed decision making. This is an excellent point.

No one is doubting the sincerity of Ian Gawler himself, although even if sincere he can still be profoundly mistaken. It is easy to understand how someone who was given a terminal diagnosis and then survived would credit whatever they did to treat themselves. This is a profound personal experience, and certainly affected the course of the Gawler’s subsequent life. It is a powerful story that will resonate with anyone facing a cancer diagnosis.

All the more reason to set the story straight, or at least point out that Gawler’s interpretation of his own story is not the only possible interpretation. This points to the fallacy of relying on anecdotes in medicine – 37 years after the fact we have no way of determining whether or not Gawler had metastatic cancer or TB. This means that his case cannot be used as evidence for the efficacy of diet and meditation in curing cancer. But that is exactly how Gawler is using it.

In his latest book, The Mind that Changes Everything, Gawler writes:

It is our mind that regulates our present and our future. Do you imagine a happier world with better health? More vitality? More success with the ability to fulfil your potential when it comes to sport, business, relationships, healing and peace of mind?

This is a typical New Age, Chopra, The Secret type of claim – if meditation can cure cancer, then the mind can do anything. It is pure wish-fulfillment fantasy, but can sound compelling when backed up by an apparent dramatic story.

In a news report on their new article, Haines is quoted as saying:

”I’ve seen beautiful young girls with their whole lives ahead of them and they go into these holistic therapies and spend hundreds of thousands of dollars and then in the end we have to look after them. They all eventually get to us.”

I need to point out that while Haines’ experience is important, it is also anecdotal. He is only seeing those patients who come to him after CAM treatment failure. It is possible that there are those who are cured that he is unaware of because they don’t “get to” him. All we can say is that there are cases of patients who pursue alternative cancer cures, they do not work, and then they present to an oncologist in an advanced stage of their disease. What we need are controlled studies of any proposed treatment to see if they are safe and effective. Of course, there are no such studies supporting the use of alternative cancer cures – that’s why they are alternative.

Gawler has believed for the last three decades that diet and meditation can cure cancer. He has spent that time writing books and promoting his personal story, convincing many others of his beliefs. While he may mean well, the far better course of action would have been to study the hypotheses that stemmed from his dramatic experience, not to conclude that he must be correct and proceed with premature conviction. That is the difference between a crank and a scientist.

In medicine well-meaning (and not-so-well-meaning, for that matter) cranks can do a lot of harm. It’s good to see mainstream doctors recognizing the risk and doing something about it.

Posted in: Cancer

Leave a Comment (26) ↓

26 thoughts on “The Cancer Cure Anecdote

  1. Hence the old oncology adage, “no meat no treat.” I’ve heard it attributed to George Canellos, but it might’ve been someone else.

    Steve, you were more polite to Gawler than he deserves.

  2. Earthman says:

    If Gawler is ‘genuinely deluded’ then he deserves sympathy, help and understanding. It is those who should know better, and who wilfully blind themselves to evidence who deserve to be condemned.

  3. Earthman says:

    My cancer has been in remission for 30 years now. Can I claim a miracle cure as does Gawler?

    Err, hang on. Mine was due to surgery, platinum drugs, and radiotherapy.

  4. Earthman says:

    My cancer has been in remission for 30 years now. Can I claim a miracle cure as does Gawler?

    Err, hang on. My cure is due to surgery, platinum drugs, and radiotherapy.

  5. Earthman says:

    It would be good if commenters could edit their submissions rather than having to re-post.

  6. weing says:

    I doubt that Gawler can ever be convinced that it was TB and not a metastatic sarcoma that was cured. He has way too much invested in this. It takes a truly big man/woman to admit that he/she was wrong. It does happen, but very rarely.

  7. mpicanco says:

    I think Steve’s tone is spot on… no need to go on the attack – also makes it more likely he’ll come around. Yeah, that’s impossible given it has been his whole life but still best to remain professional.

  8. DBonez5150 says:

    This reminds me of an anecdote I heard from a coworker. He was going on-and-on about the power of Christian Science. As a new employee, I kept my mouth shut. He said as a kid he took a spill on his bike and limped home. His Christian Science mom grabbed a bible and examined him. Sure enough, she said he had a broken femur and some other injuries. After some prayer and hand waving, a few days later, he was all better. Wow! What amazing stuff. I asked if she had an x-ray to back her findings, but he was offended that anyone would question god’s work through her. Um, okay. So, for 40+ years he’s been touting the miracle benefits of Christian Science and his amazing recovery. To me, and probably most everyone here, it’ a ridiculous story, but who knows how many times similar stories are told to vast quantities of people. And, at least she didn’t write books about her miracles and sell her abilities (that I know of) profiting from the silliness and further propagating the crap like Gawler.

  9. DVMKurmes says:

    I tend to agree with Kimball Atwood, while Gawler is probably genuinely deluded, he is also a Veterinarian who presumably should have learned not to make exactly this type of mistake at some point during his professional training. It always surprises me how many veterinarians, MDs, etc. seem to forget all they learned about science and cognitive errors as soon as they graduate. Gawler is one of those who should know better.

  10. Nikola says:

    Thank you, DVMKurmes:)
    Now I don’t have to write that comment.

  11. wertys says:

    To be as fair as possible to Gawler, his schtick is really just mindfulness meditation and positive thinking. His foundation itself is relatively benign in its approach. He is certainly not a Gerson or Burzynski. He is however somewhat of a ‘gateway guru’ and that is certainly the experience of those of us who work here in Victoria, Australia with cancer patients. We have all seen dozens of individuals who went to Gawler’s courses and were full of fairly unrealistic expectations, but my very strong suspicion is that these were ppl who would have gone the altmed route anyway. His reputation and anecdotal tales encouraged them to think they, too, could beat the odds. I wonder what Gawler would say to the families of those who went to earlier-than-necessary graves because they used his ‘inspirational’ tale as a basis for fuelling their own desire not to accept their illness and its prognosis.

    Incidentally, my parents apparently were acquainted socially with Gawler before his cancer, and they have always felt he was very intense and a bit obsessive. He was also a sub-elite athlete before the sarcoma, and high-performing athletes I have found make terrible patients when faced with serious illnesses because they are far more prone to attribution bias, ie they blame other factors for failure and claim credit themselves for any success.

  12. Jan Willem Nienhuys says:

    In the Netherlands a similar case happened. In 19809, Dr. A.J. Houtsmuller (1924), internist, got melanoma on his leg, was operated on and cured. One and a half years afterwards he had symptoms that he interpreted as caused by a metastasis of his melanoma to his right kidney. He then devised a treatment consisting of a special more or less vegetarian diet plus lots and lots of supplements (fatty fish and liver of pork and chickens were allowed), and he was cured by it, at least so he claimed. He became quite famous in propagating his diet. His books and brochures on the subject sold in the ten thousands (in a coutry of about 16 million) and he got even a sympathic ear from the Dutch Cander Foundation. In 1999, when the only known person cured by his treatment was still he himself, he had to acknowledge that the diagnosis ‘metastatic melanoma’ was never established by a proper oncologist, and that his oncologist actually had told him in 1997 that he hadn’t had metastases at all but probably a cyst.

    Then the Dutch Association against Quackery (DAaQ) called him publicly a liar and a quack. Houtsmuller sued the DAaQ for defamation and lost. Thereupon Houtsmuller stopped seeing patients, but also appealed. In the year 2000 the appeal judges said that quack and liar were well known strong invectives, even though the DAaQ had insisted that they used quackery only to mean ‘the profession of unscientific medicine’. The DAaQ did not further appeal, but when another quack doctor (a kind of chiropractor named Sickesz (1923) who claimed she could diagnose and treat autism, epilepsy and schizophrenia by touching and adjusting the neck vertrebrae) sued the DAaQ for similar reasons the DAaQ appealed to the Dutch Supreme Court who acknowledged the DAaQ’s right to call people quacks if they made it clear what they meant. More precisely: given the fact that the DAaQ says precisely what they mean by quack, the relative importance of the freedom of speech versus protection against defamation must be argued much more closely than the lower court did, so the juridical proceedings should be repeated in another lower court.

  13. BillyJoe says:

    It took 35 years for someone to come up with this alternative diagnosis, so it’s a bit tough to expect Gawler to accept that explanation for his illness, especially as it is speculative and unproven.
    Previously, the only explanation that I have heard is that he had a spontaneous remission. I was never quite comfortable with that explanation – has there ever been another case of metastatic osteosarcoma (he supposedly had deposits in his regional lymph nodes, lung and sternum) remitting spontaneously?
    It is satisfying now to be able to discard that explanation, but I wonder why it took 35 years?

  14. daedalus2u says:

    There are other alternatives too. Going through a severe infection causes the immune system to do things which are not well understood and which could/do have effects on tumors. There were attempts to use bacterial infections to treat tumors (Coley’s toxins)

    and these treatments did appear to have some success.

    Using natural toxins from bacteria, or the bacteria themselves would be expected to be complicated because of idiosyncratic variability between toxins, bacteria, and the immune system state of the individuals being treated. Because bacterial toxins are “natural”, there are evolved pathways that react on exposure. Those pathways are highly dependent on the individual’s immune system status and prior exposures. Because of this, the responses are highly non-linear and so difficult to test in the laboratory and difficult to extrapolate between experimental animals and humans both collectively and individually.

    Chemotherapy with xenobiotics is much simpler.

    The idea that the TB infection somehow contributed to or caused the tumors to regress (if there were any tumors at all), is I think more likely (because infections have been observed to cause tumors to regress) than a vegetarian diet and fruit juices (which has not been observed to have anti-tumor effects).

  15. pmoran says:

    I don’t think chronic infections like TB were ever associated with cancer regression, Daedalus2, but there were some interesting results with Coley’s toxins when used aggressively.

    A comment of mine that explains how they were used —

    I agree with Billyjoe – if the present interpretation of events is true, as is likely, a very serious medical error helped persuade Gawler of the merit of the “alternative” methods he chose.

  16. pmoran says:

    This is odd. I sent a link to the above post to persons with an immediate interest in the matter, but they are unable to find out how to register so as to make a comment. Neither can I, for now.

    How is this done, and should not a registration option be available on the home page?

    1. Harriet Hall says:

      @pmoran, “should not a registration option be available on the home page?”
      It is.
      Right side of page, scroll down past “Categories” and “Staff” to “Meta” and click on the “Register” tab.

  17. pmoran says:

    Yes, found it on other pages. The “Register” option simply doesn’t appear under “Meta” when when using the link that I sent via email. Try it —

  18. Harriet Hall says:

    Does it go away once you have registered, perhaps?
    It doesn’t appear on my computer, but it does on my husband’s computer.

  19. pmoran says:

    That may be it, Harriet.

    I am now advised that the registration does not seem to be working — the emails confirming passwords are not being received. Can someone check?

  20. My cancer has been in remission for over 25 years. I occasionally smoke cigars, eat big greasy steaks, and have 2 huge cups of coffee in the morning (and not in enemas), and continue to be in remission. If I play this right, I can get a huge payment from Big Cattle, write a book, and be set for life.

    Anyways, people want the easy way out of their problems. A pill to lose weight or stop smoking. A fruit to cure their cancer. People want Gawlers. They want these stories.

  21. libby says:

    Well written post.

    Gawler’s error is one in inductive reasoning. projecting a specific incident onto a general claim. That’s why when I successfully use alternative medicine, like homeopathy, I never say to anyone that from my experience it follows that they do the same.

    However it also does not follow that a singular experience is necessarily negated by general principles (a deductive reasoning error), especially principles based on erroneous concepts, such as the Newtonian/Cartesian idea that the body is simply a machine.

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