Quintessentially Quilly

Francisco Contreras, M.D.
and
Daniel Kennedy, MC

I(Francisco Contreras) must have been daydreaming, but the vision in my mind certainly seemed real. I saw a beautiful tenyear-old girl staring at me over the nameplate on my desk: Dr. Francisco Contreras, Surgical Oncologist.“My name is Sarah. Who are you?”

“I am Dr. Contreras,” I replied. “And who are you?”At that point I quickly reviewed Sarah’s case notes and began to interview her and her parents. Ever since Sarah first noticed a big lump on her arm a year or so before, she had spent more time in medical institutions than at school or at home. She had already endured one surgery, after which she had hoped that everything would again be all right.Yet her parents still acted strangely when she was around. They weren’t as strict as they’d once been, and they spent many hours behind closed doors crying. Sarah began to wonder if the big term the doctor had used to explain her problem had upset her parents. It took her weeks to learn

how to pronounce and spell it: non-Hodgkin’s lymphoma. Whatever it was, Sarah knew it wasn’t good. Her parents told her, “The doctors are offering you chemotherapy, but they said it wouldn’t help you much. What do you want to do?” “I know I am in God’s hands, and I have peace,” Sarah replied. Her parents decided to look for a different approach. That is when Sarah became our patient at Oasis of Hope.“Dr. Contreras . . . Dr. Contreras . . . Dr. Contreras . . . ” Suddenly, I snapped out of my daydream in response to the voice of an angelic vision of beauty standing before me dressed in a wedding gown. It was Sarah! “Can it be true that twelve years have passed since God delivered Sarah from cancer?” I asked myself. My wife and I then took our seats to witness one of the most inspiring weddings we have ever attended.

All of Sarah’s family and friends were there. We were sitting in the next-to-the-last pew, where I suddenly found myself crying so uncontrollably I began to worry that I’d use up all the moisture in my body. The joy I felt was overwhelming.

Soon Sarah stood at the altar with the young man of her dreams, who immediately became the envy of every bachelor who had ever met Sarah. I only wished that I had a son old enough to marry this lovely, talented, sweet young woman, thus bringing her forever into my own family!

Sarah credits God, her parents, and my father, Dr. Ernesto Contreras Sr., for her victory over cancer. She is right to do so, but I would add to that list her own determination, starting when she was just a little girl. She now is a college graduate and serves the Lord with her husband, who is the pastor of their youth group. They also have a precious little boy.

How was she able to overcome the insurmountable? Four words come to mind: openness, flexibility, adaptability, and commitment. Sarah and her parents looked beyond the tunnel-vision, chemotherapeutic attack on cancer that had already failed. They opened themselves up to other options. They were flexible and willing to try new treatments. They were able to adapt to different circumstances.

Above all else, they were totally committed to seeing Sarah well again. And perhaps all of that, taken together, explains why they were able to embrace an eclectic, multifaceted approach that depended on them every bit as much as it did on the doctors.

It All Begins With Philosophy

Sometimes chemotherapy and radiation work, and sometimes they don’t. If you and your doctor subscribe to the philosophy that you will have no hope if the medicine doesn’t work, then you won’t have any such hope. Your philosophy will either limit your possibilities or open them up.

My point is that everything begins and ends with philosophy—the paradigm by which we frame every aspect of our existence, the filter that helps us to decide how and what we think. If you doubt, simply consider the entire academic world. It doesn’t matter what field a person might choose; the highest degree is a Doctor of Philosophy (abbreviated as

PhD). You can get a PhD in immunology, anthropology, mathematics, literature, and many other disciplines as well.

Perhaps as a natural consequence, the philosophy of medicine, as birthed in the early twentieth century, has evolved into the treatment paradigm of the twenty-first century. Think about that for a moment! The twentieth century was an era of scientific breakthrough and technological advance, yet we began it without electricity, television, airplanes, and computers.

The scientific and technological revolutions of the twentieth century had a profound impact on the medical field as well. Scientists developed an arsenal of pharmaceuticals designed to address just about every pathogen. Meanwhile, even as I write these words, new technologies such as lasers, 3-D imaging devices, proton therapy, robotic surgery,

DNA laboratory exams, cyberknives, and fiber-optic cameras are assisting physicians in the field. The results of all these advances have been impressive.

For example, acute medicine is now at the top of its game. Doctors can save life and limb in ways never before thought possible. If Humpty Dumpty had been brought to a modern trauma center, he would have gone back together in no time at all.

In addition, once-complex medical procedures such as angioplasty and open-heart surgery have now become routine. People don’t fret anywhere near as much as they used to when they go under the knife. Technology has transformed the operating room into a much more controlled environment than ever before.

Overall, we owe the scientific method for most of the important advances in medicine. Science has awed all of us at one time or another, and it continues to do so on a regular basis. The development of scientific methodology has evolved to such an extent that not even the sky is the limit anymore. In fact, every month I put some money in my piggybank because I want to go on the first commercial trip to outer space!

Inner space has been no match for scientific methodology either. It took less than two decades for scientists to unravel the trillions of letters of the human genome, the code of life.

Again, most projects like that have conquered outer and inner space because of vision, intelligence, planning, and perseverance, combined with adequate funding and strict adherence to scientific methods. Thus many tasks once thought impossible have now been made almost routine.

But somewhere in the shadow of all these scientific victories, cancer still lurks as the unconquered enemy. Hundreds of years after it was first identified, cancer in most (or all) of its forms still manages to evade, elude, and confound the best efforts of the best scientists.

The old Way Just Doesn’t Work!

When faced with monumental challenges, scientists of all disciplines must first learn all they can about what they want to conquer—the moon, bacteria, or cancer. Experts of all disciplines generally evaluate each challenge through a process called SWOT (strengths, weaknesses, opportunities, and threats). They analyze everything on both sides of the

equation, including their own SWOTs, before they can hope to map out a strategic action plan.

As in conventional warfare, scientific theory says that the side with more strengths and opportunities should overcome the side with the most weaknesses and the least chance to evade and avoid threats. Yet until now, cancer has defied everything that science has thrown at it. It has dodged or defeated every hopeful advance. After four decades of

tireless efforts by countless scientists around the world spending hundreds of billions of research dollars, the conquest of cancer still seems out of reach.

Is all this true because the scientific method is not as effective as we once thought? Or is it because cancer’s strengths are insurmountable?

My answer to both questions is an emphatic no! I am convinced that tackling cancer from a different perspective will generate positive results. Current treatment and research paradigms have literally become the problem, as embodied within two fundamental aspects of that framework: (1) the methods and (2) the goals of modern research.

Many of the treatments being explored today do not have as their goal a complete cure for cancer. Instead, the goal is a drug treatment to hinder and slow the progress of this dreaded disease. While drug treatments can lessen the impact of cancer, making it a chronic disease that does not end in death, it is important to remember that there are no

“magic bullets.”

Put another way, I feel the goal of pharmaceutical companies and the

U.S. Food and Drug Administration (FDA) is to isolate the single agent that could bring about “the cure.” But cancer has many different causes. Therefore there is no one substance that will cure it in all instances and in all people. We must use great caution when applying new drug therapies and never forget the need for personally tailored medical treatment. Will Health-Care reform Be the Answer?

I’m sure that with the health-care reform currently being enacted, more Americans will have access to medical management, but inevitably it also means that the care will be diluted. For instance, in England many drugs available in the United States are off limits, and waiting time for doctor’s appointments, scheduled scans and surgeries, etc. are quite long. Now more than ever we should take responsibility for our health and do all we can to prevent loss of our health through preventive measures in order to depend as little as possible on government health-care systems.

Health-care reform is a topic that I watch carefully. I am always on alert of how government regulation will limit or improve my ability to help patients beat cancer. I believe that many more people could be cured of cancer just through health-care reform. I am tempted to get excited when I hear politicians begin to take on the challenge of reforming how health care is delivered. But the sad reality is that it really isn’t about health-care reform. It is really about payer reform, that is to say, who is going to pay, how it will be paid, and what will be paid for.

When the focus is about the payment of health care, the care made available to patients usually is brought down to the least common denominator. I have seen this firsthand in Mexico where medicine is socialized, which means the government runs the hospitals and everybody has equal access to health care. But the reality is that while everybody has

equal access, not everybody has access to equal levels of treatment. To get the latest cancer treatments, which are always the most expensive drugs, only people who can go outside of the system and pay cash will have the chance to get those treatments. The government-run hospitals have limited resources that have to be spread out to cover everybody. This limits patients’ access to the best treatments.

Imagine that you have prepared soup for ten people, but one hundred arrived, and you have no more ingredients. You may have to add a lot of water. Now the nutritional value each of the one hundred receives is far less than what the original ten would have received. Watered-down health care is what will be delivered if the focus on health-care reform continues to be about who will pay what.

The health-care reform that we need should be focused on health. We need to start changing our research funding policies. Today, the National Cancer Institute (NCI), a branch of the National Institutes of Health (NIH), dedicates less than 2 percent of its budget to researching how to prevent cancer. This is tragic because every year, the incidence of cancer increases. The amount of money spent on treatment continues to

balloon because more and more people are getting sick. The true cure to cancer is to never get it at all. If more research dollars were spent on prevention, and preventative measures were found and implemented, there would be hope for fewer people ever getting cancer. The money spent on treatment would then decline and the vicious cycle could be broken.

The other shift in research that is needed is for fewer studies to be done on drug therapies and more studies to be done on natural therapies. I am enthusiastic because there are more studies underway in the arena of natural therapies at major institutions than ever before.

The biggest way to improve how patients are treated would be to do away with malpractice insurance. The best high-wire artists have always been the ones who have walked that narrow path without a safety net. If a doctor is treating you without the malpractice safety net, he or she will spend more time with you to make sure you receive the highest quality of care as well as the friendliest care. But listen, I am a doctor, so I

am not coming against doctors with this suggestion. I am really against the system that rewards money for improper or negligent health care. It should not be about the money. It should be about the quality of health care. If a patient or the family member feels that the care was negligent or even criminal, the claim should be made to the medical boards and

it should be about the physician’s license, not about cash awards. If the medical board would find the doctor guilty of malpractice, his or her license could be revoked or suspended until the physician received further training and correction. This would bring the focus back to health care, not money.

Even as I am writing this, I am just two days away from a visit from Patch Adams to the Oasis of Hope. In his dream hospital, no doctor would ever be allowed to carry malpractice insurance. He believes that doctors must become real friends with a patient and that a patient would never sue the doctor if they knew that the doctor really cared for them. Patch and I will have a conversation on camera on the healing power of the doctor-patient relationship, and by the time this book gets into your hand, you will be able to see the video online at www.oasisofhope.com. Please visit the website and watch the video. I am sure that it will be quite interesting.

Where Are We going, and How Will We get There?

In the spring of 2004, Fortune magazine featured a riveting cover of solid black with a big red headline: “Why We Are Losing the War Against Cancer.” The subtitle added, “And How We Can Win It.” My immediate reaction was to wonder why they had taken such a negative approach. I was well aware of how badly we need to get the upper hand, but even I was shocked to read their inside information on cancer research.

The author explained that more than $14 billion in private and government funds are spent in America every year on searching for the cure, but little progress has been made. Each research project is managed independently, and the various research centers do not share information with one another.

Remember the story of the six blind men trying to describe an elephant? Each man touches a different part of the elephant, such as the leg, tail, and tusk. They then describe the elephant based on the one part that they felt and discover they completely disagree with each other. The story illustrates the misconceptions that can come about when a

person’s perspective is limited to one small piece of a bigger picture. Clearly, no one in cancer research is working with the big picture. And yet, according to Fortune, we could win the war against cancer if the National Institutes of Health would obligate researchers to share information and coordinate their efforts.

Sadly, I agree that more information sharing would be beneficial, but I doubt that one single remedy would be enough. The more basic problem is that researchers are starting from the wrong place, and they’re aiming for a destination that probably doesn’t exist. Let me repeat what I hope I have already made plain: I don’t think the cure to cancer exists in the form of one substance, technique, or apparatus. I do believe that cancer can be defeated, but only through a multifaceted, eclectic approach.

Let me rephrase this in simpler terms. The search for a magic bullet is a waste of time and resources. It is tantamount to chasing rainbows, hoping to find that elusive pot of gold at the end.

Such an approach reminds me of the always-broke investors who aim only for the “big score,” in contrast to the professionals who take a little bit of profit from every little trade and wind up rich.

Likewise, science has uncovered many, many things that can diminish the power of cancer, but the goal of many in the research community remains that one huge score.

Our goal is to share with you the many “small” things you can do to minimize cancer’s advantages. This means you must consider your doctor a member of your treatment team, not your boss. You must take responsibility for your own health and make informed decisions. Do not accept the status quo!

Approach cancer from every viable angle you can identify. In so doing you will develop a powerful personal philosophy, and you will put policies in place that will serve you well in your mission to undermine cancer.

That is precisely what Sarah and her parents did, and it worked. She has now been free of cancer for more than twenty years.