Forbidden Medicine

CURLED UP BAREFOOT IN an overstuffed armchair, Margarita Amico delivers grapes to her mouth one by one to keep the post-chemo nausea at bay. Her right forearm is attached to a passageway of plastic tubing that climbs straight up over her shoulder to a standard IV drip unit. But these drips contain something much different from the toxic chemotherapy she’s been receiving. The serene woman, with her shock of just-barely-there gray hair, accepts this intravenous nourishment gladly because she believes it will help combat the mutation, the deviation, the thickening in her breast.

At first, the misshapen cells were content simply to advance inside her—to multiply and establish a battleground. But soon they sought dominance. The situation turned dangerous, uncontrollable, like mob violence.The cancer threatened to take her life.

Now the IV unit releases its “alternative” elixir of vitamins, supplements and natural substances into her body. Since many of the treatments offered here in Dr. Douglas Brodie’s office are illegal in California, Amico has had to travel from the Sacramento area to Reno for this therapy—what she calls her “boost.”

Brodie was once a lightning rod for controversy. In the 1970s, California’s Board of Medical Quality Assurance, as the state’s medical oversight group was then called, targeted the doctor for embracing a medical doctrine that emphasized “unconventional cancer modalities.” Regulators put him on probation and attempted on multiple occasions to take away his medical license.

Today, Brodie has a thriving practice in Reno—the new destination of choice for many thousands of cancer patients from around the world, who seek alternative and “holistic” therapies for cancer and other diseases.

Sitting in the armchair, taking her IV treatment along with the half-dozen other cancer patients who today occupy Brodie’s infusion room, Amico knows full well that Brodie “had his troubles” back in California. But she has no qualms about her decision to add his alternative therapy to her conventional medical regime for breast cancer. “Dr. Brodie helps build me up,” she says. “He helps my body be strong.”

IT IS NO EXAGGERATION TO say that every American adult alive in 2002 knows someone who has been diagnosed, suffered and possibly died from cancer. Mother, sister, father, friend—it’s hard to understate just how deeply rooted this disease is in the hearts and minds of the ordinary individual. For this reason, many arrive at any discussion of a treatment with a personal history, with emotions flared and fear attendant.

Following conventional medical wisdom seems logical. And when it comes to cancer, convention often leads in just one direction, to the “big three” treatment modalities: surgery, radiation and chemotherapy. But even the most traditional medical experts admit that the “three,” though successful in forcing a steady percentage of remissions, are ultimately toxic strategies that have been something of a statistical failure.

The mortality rate shows a slight decrease these last years, but the incidence of cancer continues to climb dramatically, according to the American Cancer Society. Almost 1.3 million new cancer cases are expected to be diagnosed this year; 600,000 Americans will likely die of the disease in 2002. Even the standard-bearer of conventional doctoring, the New England Journal of Medicine, writes that despite more than $20 billion poured into cancer research, the ultimate result has been nothing less than a “qualified failure.”

For this reason, some cancer patients eschew traditional medicine entirely and turn completely to alternative therapies. A much larger percentage chooses to combine the tactics of conventional and non-conventional medicine, to seek a mix that has become known as “complementary” cancer care.

But they’d better not look for the alternative option in California. Somehow, this hotbed of health consciousness and New Age culture has also become the least favorable state in the union when it comes to alternative treatments for cancer.

From his Reno office, safely across the Nevada state border from where he was almost shut down, Brodie laughs politely when asked what would happen if he tried to reconvene his practice in California today.

“I’d be in jail right now,” he says.

LIKE MANY PHYSICIANS, Brodie has furnished his waiting room with comfortable couches, polite armchairs and piles of magazines. But a visitor here is likely to find copies of Vegetarian Times and Homeopathy Today on the side table instead of Fortune and Time. The controversial 76-year-old, wearing Lands End loafers and a standard white coat, exudes the calm air of a man who learned long ago that speaking his mind might come at a price.

In a measured tone, Brodie describes his own conversion to alternative medicine. The seed, he says, was planted back in 1955, when, after earning a medical degree from the University of Michigan and serving for three years in the military, he began a term as chief medical resident at the Highland-Alameda County Hospital in Oakland. One of his duties was overseeing the cancer ward.

“I watched them get sicker and sicker,” he says, describing the vomiting, nausea, malaise, anemia and hair loss. “It was my observation that, almost without exception, those cancer patients were in worse condition during and after their chemotherapy than they had been before.”

By the 1970s, Brodie began believing that what American medicine thinks about cancer was “wrong most of the time,” he says. “Cancer patients suffer from impaired immune systems. In fact, some of us think that cancer occurs as a result of an impaired or deficient immune system.”

Brodie also developed a belief that certain entities benefited mightily from the strict allegiance to conventional therapies. He came to accept that the pharmaceutical industry was a lead player in what he calls “Cancer, Inc."—a spider’s web of public-private-academic research laboratories, cancer nonprofits, research bodies and spin-off industries that benefited from an all-out allegiance to the big three: surgery, chemotherapy and radiation.

“We’re talking about an established monopoly which, despite some progress, continues to vigorously oppose the development of alternative or natural methods of dealing with cancer,” Brodie says. “It’s a monopoly of thought as well as a monopoly of methodology.”

Dr. Sidney Scudder, chief of clinical affairs for hematology and oncology for UC Davis Medical Center in Sacramento, bristles when he hears such sentiments. “Many of the alternative providers believe the U.S. government isn’t doing all it can to fight cancer, and that’s completely ridiculous,” he says. “They think conventional doctors don’t want to cure you. Give me a break!”

A reputable physician who has practiced conventional cancer care for 20 years, Scudder adds that treatments have improved significantly since the “bad old days” of cancer care 20 years ago. From his perspective, outcomes are “tremendously better than they used to be for cancer patients. The toxicity [with chemotherapy] is still there, but the tools we have to deal with it are much better.”

It was the mid-'70s when Brodie’s practice drew the attention of the Board of Medical Quality Assurance in California. “They came after me,” he says. He learned of the first BMQA charges by reading a local newspaper headline: “Warrant Issued for Doctor’s Arrest” under which it read “Physician Charged with 23 Felonies.” To Brodie’s horror, the article turned out to be about him. He had been issued no warrant, nor received notification on any pending arrest.

The felonies turned out to be 23 individual alleged “over-prescriptions” and the board later admitted in court that it had made an error in calling these felonies. The prescriptions themselves involved four patients, one of whom was a young man with Buerger’s disease, who had both legs amputated at the hip and both arms amputated at the forearm.

“These were patients with chronic, intractable pain who, in my opinion, required narcotics,” Brodie says. But court documents allege that Brodie practiced a pattern of prescriptions with this man and the three other patients that constituted “clearly excessive prescribing of drugs.”

Eventually, Brodie was exonerated of wrongdoing. But the BMQA came back a second time, charging him once again with over-prescribing. Once again, Brodie was exonerated. Though court records make no mention of his controversial cancer therapy as an issue, Brodie feels certain he was being singled out for this reason. “It was widely known that these attacks on my license were because of my use of Laetrile and unorthodox approach to the treatment of cancer,” he says.

Frank Cuny, legislative advocate for Citizens for Health, confirms that, in his experience, the charge of over-prescribing narcotics is a common method of attack when state regulators want to punish or “get rid” of a controversial doctor. “It’s difficult to discipline a doctor when it comes to alternative practices, so they hit them with something else,” Cuny says.

When the board charged Brodie for the third time, it was one time too many. The constant struggle had taken its toll. “I decided I just didn’t want to fight with them anymore,” Brodie says. In the late-'70s, he left his home in Tahoe City and moved 15 miles across the state line to Incline Village. A decade later, he moved to Reno, continued his practice and, in 1997, wrote an independently published book, Cancer and Common Sense: Combining Science and Nature to Control Cancer, which depicts cancer as a battleground—not just inside human bodies, but also when it comes to politics, profits and principle.

Interestingly, shortly after his move to Nevada, the state of California passed a new law making it a felony for a physician to offer any substance or procedure to a cancer patient other than chemotherapy, radiation and surgery.

PETE RIOLO KNOWS WHAT it’s like to do battle. A former detective with the Sacramento Police Department, Riolo retired and went on disability at age 59 after taking a bullet to the back in the line of duty. Sitting on a couch in his single-story suburban home, Riolo, now 72, does not mince words about how he felt in February 1997 when he learned he had prostate cancer.

“I was stunned,” he says simply. “I could hardly find my way out the door.”

A series of medical appointments at the powerful California HMO that insured him reinforced the original diagnosis. In fact, Riolo says the doctors told him his PSA (prostate-specific antigen) level was so high it wouldn’t do any good to operate. (When this type of cancer is caught early enough, doctors usually remove the prostate as a first strategy for cancer control, though this doesn’t always work and may cause impotence and incontinence.)

One doctor told Riolo he had six years to live; another told him he had three. One administered a “hormone blocker” shot called Lupron to keep the cancer at bay. A doctor Riolo later dubbed “Bela Lugosi,” after the legendary horror film actor, told the ex-cop that if a Lupron shot didn’t stop the advance of the cancer, the hospital would have no choice, Riolo says, but to “cut off his testicles.”

All told, Riolo says he saw four different doctors about his cancer. They all repeated a terminal diagnosis. “They wanted to bury me,” Riolo says now with measured anger in his voice.

Not one to give up without a fight, Riolo began to do exactly what you might expect a former detective to do. He gathered evidence, sorted information and interviewed people who had experience with cancer.

His research led him to believe that the pharmaceutical industry had a vested interest in supporting only conventional modalities for cancer, since it could never make money off natural substances that could not be patented. Indeed, the bible for those seeking well-researched information about complementary cancer care, Choices in Healing by Michael Lerner, agrees that the pharmaceutical industry is a powerful force in American medicine, business and politics. “The industry must make large profits to realize a return on investment, particularly in a regulatory system where it costs $100 to $200 million to bring a new drug to market. In this environment, drugs that cannot be patented are of little financial interest to the industry.”

Ex-cop Riolo puts a more succinct spin on things: “I learned that making money, not finding cures, is what conventional medicine is interested in.”

In March 1997, Riolo’s search led him to Brodie, who told him, simply, that he could help him control the cancer. Riolo’s PSA level had recently been charted at a frighteningly elevated level of 71.4. (Anything above 4.0 is a red flag for prostate cancer.) But Brodie told Riolo not to worry; he could help him get his PSA down.

“Until Dr. Brodie, I felt like a man without a country,” Riolo says. For the first time, the stricken man felt there was hope.

In April 1997, Riolo and his wife traveled to Brodie’s Reno clinic for two weeks’ worth of daily IV infusion treatment sessions designed to strengthen his immune system. The infusions consisted of mega-doses of vitamins A and C, thymus, digestive enzymes, shark cartilage, antioxidants, germanium and CoQ10, an immune system enhancing enzyme, as well as other natural substances.

For some patients, Brodie includes Laetrile in the IV drips.

“I still find it useful,” he says of the controversial substance, sometimes called vitamin B-17. The “cancer establishment” waged a successful PR war against Laetrile in the 1970s, Brodie says, and it forced the medical community to fall in line with the perspective that the substance was dangerous. But Brodie vigorously defends its use.

“It’s not a cure-all; it’s not a panacea,” he says. “But it helps.”

UCDMC’s Scudder contends that Laetrile is not an effective cancer treatment.

“In the U.S., clinical trials showed Laetrile didn’t do anything for cancer,” he says. Even alternative health guru Dr. Andrew Weil, on his Web site, agrees that Laetrile has never been proved effective and is “a worthless cancer treatment.”

Riolo’s PSA level continued to decrease. When he went home, Brodie put him on a diet program that favored fresh fruits and vegetables as well as whole grains and beans. He advised Riolo to avoid foods that were high in fats and refined sugars, as they, Brodie says, would “feed the fire of cancer.” The importance of phytochemicals was emphasized—these are plant extracts one can find in such cruciferous vegetables as broccoli, cabbage, cauliflower and Brussels sprouts.

Riolo, who spent more than $7,000 on Brodie’s intravenous and oral treatments in 1997, began to apply the diet, took the recommended oral vitamins and supplements and began a regular course of physical exercise throughout the spring and summer.

Soon Riolo told Brodie he was thinking of going even further in his search for healing. He’d investigated a program at the Hospital Santa Monica, just south of Tijuana in Mexico, and wanted to undergo its three-week cancer care treatment. Brodie told Riolo he had “no qualms” about that. To many, such a hospital represents the quintessence of quack. The well-publicized 1980 death of Steve McQueen, age 50, at an “alternative” cancer hospital in Mexico represents a solitary—and very negative—association with such hospitals. However, others believe such places, all of which operate outside the FDA-approved guidelines on safe medical practices, are sanctuaries for doctors who aid healing and may even “cure” cancer.

Riolo spent $17,000 out of his own pocket for a three-week stay at the hospital in Mexico and has only positive things to say about his stay. “I was seeing cancer cured there right before my very eyes,” he says. However, as conventional doctors would advise, cancer is known to go into spontaneous and rapid remission, regardless of treatment.

When Riolo got home, his PSA had dropped to 7.0, a reading that still indicated prostate cancer but showed a dramatic reversal. He continued on a home treatment plans that integrated Brodie’s vitamins, natural supplements and PC-SPES (a combination of mostly Chinese herbs that the FDA recently outlawed as dangerous) as well as other products only available in Mexico.

Riolo took his last Lupron shot in June 1998. By August of that year, following the treatment plan of Brodie and the hospital in Mexico, Riolo’s PSA level dropped down to 1.0. But that wasn’t it. For the past two years, using only alternative treatments and natural medicines, Riolo’s PSA reading seems to have stabilized at a striking 0.1. His conventional doctors don’t quite know how to explain this. They had given a death sentence to a man who now seems free of cancer.

Today, Riolo appears vigorous and healthy for his age. He goes to the gym three times a week and feels “real good” these days. “I learned how it works,” he says. “I’ll go to a regular doctor’s hospital if I’m in an auto accident or something like that, or for a tetanus shot. But I’ll never go there for cancer. They can’t drag me there for cancer.”

THERE IS ONE PARADIGM that teaches that disease is external to the body; that one must isolate and destroy it. But there is another view that instructs that wellness is created by an interaction of internal and external environments. In this paradigm, the mind and body are integrated. Cancer is seen as a systemic disease, not a localized tumor that just happens to appear in a particular part of the body.

Brodie—and a handful of other alternative cancer care physicians operating in Reno—clearly embraces the latter paradigm. His logic goes like this: If there are many interacting factors that contribute to the formation of cancer, so must there be multiple treatments that can contribute to its demise. “Basically, we believe in the body’s ability to fight cancer,” Brodie says. “We do not seek to replace or eliminate traditional methods. … Our methods can and should be complementary to them.”

Alternative medicine is growing in acceptance, Brodie says. Indeed, some studies indicate that half of all Americans diagnosed with cancer each year now seek complementary care. It’s important to note, in this context, that many cancer patients seek such care for sheer quality of life purposes, i.e. after a terminal diagnosis they choose to live out the rest of their lives without undergoing the toxic effects of chemotherapy or radiation.

When asked how many cancer patients die after an alternative course of treatment, Brodie responds that, of course, as with conventional medicine, many diagnosed with terminal cancer do die. He reiterates that most of his practice is complementary to conventional treatment.

Dr. James Forsythe, a Reno oncologist who also provides complementary cancer care, agrees that awareness of alternatives has risen. But the traditional remains the path of least resistance, he says.

“I go to conferences and I don’t hear a word about using anything but pharmaceutical drugs for cancer,” he says. “They believe alternative therapies have no basis in fact—no thousand-patient, double-blind control studies.”

In fact, Forsythe believes most alternative approaches will never have the “basis in fact” that conventional medicine requires. “You’re not just doing one thing with a patient,” he says. “You’re doing a combination of things. So it’s very hard statistically to evaluate what’s having impact.”

Meanwhile, conventional physicians like Scudder continue to prescribe cancer treatments that have been found to be “safe and effective” after testing that follows a strict set of scientific guidelines. “We really are working on these things,” Scudder says, pointing to the many studies now underway, for example, on the subject of how nutrition may affect cancer. “But it will probably be our children or grandchildren who will benefit from the research that’s going on now.”

Today, when Pete Riolo opens the cabinet above his kitchen counter, instead of condiments and canned goods, there reside dozens of accumulated containers full of vitamins, supplements and other barely pronounceable natural products. The cupboard looks like the homeopathic section at the local natural foods co-op.

The fact that the ex-cop has been cancer-free for two years now seems presumably to do with these products, a three-week stay at a hospital in Mexico and Brodie’s “forbidden” medical treatments. Ultimately, Riolo’s tale of survival is one anecdotal story in a sea of others that might be told, from conventional and non-conventional perspectives, about those who have experienced this deadly disease. Still, Riolo is now a true believer in alternative medicine and wants desperately to get the word out to men suffering from prostate cancer. He hopes to someday write a book detailing his cancer recovery.

“People don’t know they don’t have to die,” he says.

Meanwhile, now midway through conventional radiation treatments, Margarita Amico eats her grapes, receives Brodie’s alternative medicine through the IV and pins her hopes on the dual approach. She prays for a future when patients like her can benefit from the best medicine there is to offer without it being judged more or less worthy for being “conventional” or “non-conventional.”

She takes a deep breath when asked if she has learned any life lessons from her journey with cancer. Slowly, Amico speaks.

“Tell them it’s about learning to be comfortable with who you are. Tell them it’s about being connected in your mind and body and spirit. And tell them we should get to choose."