• unlimited access with print and download
    $ 37 00
  • read full document, no print or download, expires after 72 hours
    $ 4 99
More info
Unlimited access including download and printing, plus availability for reading and annotating in your in your Udini library.
  • Access to this article in your Udini library for 72 hours from purchase.
  • The article will not be available for download or print.
  • Upgrade to the full version of this document at a reduced price.
  • Your trial access payment is credited when purchasing the full version.
Buy
Continue searching

Spontaneous Remission of Cancer: Theories from Healers, Physicians, and Cancer Survivors

Dissertation
Author: Kelly Ann Turner
Abstract:
Background. Spontaneous Remission (SR) of cancer is defined as "the disappearance, complete or incomplete, of cancer without medical treatment, or with treatment that is considered inadequate to produce the resulting disappearance of disease symptoms or tumor" (O'Regan, 1995, p. 2). Purpose. This study sought to answer two questions: (1) What causative theories do alternative healers, physicians, and SR survivors propose for SR?; and, (2) Do SR survivors have a strong Sense of Coherence (SOC)? Methods. Healers and physicians from 11 countries (n 1 =50) and SR survivors (n2 =20) were interviewed in-depth; 17 of the 20 cancer survivors also completed an SOC scale. Results. Six treatments that may elicit SR emerged frequently among both SR and Healer/Physician subjects: (1) Deepening one's spirituality; (2) Trusting in intuition regarding health decisions; (3) Releasing negative and/or repressed emotions; (4) Feeling love/joy/happiness; (5) Changing one's diet; and, (6) Taking herbal/vitamin supplements. In addition, three underlying theories about health emerged: (1) In order to remit cancer, one must change the underlying conditions that allow it to thrive; (2) Illness=Blockage/Slowness; Health=No Blockage/Movement; and, (3) A body-mind-spirit interaction exists. SOC scale results tentatively indicate that SR subjects may have a higher SOC than general populations, but not than other cancer survivors. Implications. Researchers are encouraged to use the results of this study to design research studies that assess the impact that these six treatments and three theories may have on cancer survival.

i Table of Contents Introduction.....................................................................................................................................1   Literature Review............................................................................................................................3   History of Spontaneous Remission (SR) Research.....................................................................3   Incidence of Spontaneous Remission (SR).................................................................................5   Reasons to Study Spontaneous Remission (SR).........................................................................6   Physiological Hypotheses of Spontaneous Remission (SR).......................................................7   Psychological Hypotheses of Spontaneous Remission (SR)......................................................8   Current Challenges......................................................................................................................9   Next Steps.................................................................................................................................10   Theoretical Background................................................................................................................11   Salutogenesis.............................................................................................................................11   Salutogenesis in this Study.......................................................................................................12   Sense of Coherence...................................................................................................................12   ‘Sense of Coherence’ and Health..............................................................................................14   ‘Sense of Coherence’ in this Study...........................................................................................14   Mechanisms of ‘Sense of Coherence’.......................................................................................15   Psycho-Neuro-Immunology Mechanisms................................................................................16   Conclusion................................................................................................................................17   Methods.........................................................................................................................................18   Design.......................................................................................................................................18   Sample & Study Sites...............................................................................................................18   Sampling Strategy.....................................................................................................................23   Recruitment & Retention..........................................................................................................24   Measures...................................................................................................................................25   Procedures.................................................................................................................................26   Analytic Strategy......................................................................................................................27   Reliability & Validity...............................................................................................................28   Ethical Issues............................................................................................................................28   Conclusion................................................................................................................................29   Findings........................................................................................................................................30   Qualitative Findings..................................................................................................................30   Underlying beliefs.................................................................................................................30   Frequent treatments among healers and SR subjects............................................................42   Frequent treatments among SR subjects...............................................................................54   Frequent treatments among healers......................................................................................57   Qualitative findings summary...............................................................................................60   Quantitative Findings................................................................................................................61   Discussion.....................................................................................................................................63   Research Question #1...............................................................................................................63   Treatments for cancer...........................................................................................................63   Underlying beliefs.................................................................................................................68   Applicability to Other Diseases............................................................................................72   Research Question #1 Summary...........................................................................................74   Research Question #2...............................................................................................................75   Limitations................................................................................................................................76   Implications...............................................................................................................................78  

ii Theoretical implications........................................................................................................78   Research implications...........................................................................................................79   Practice implications.............................................................................................................80   References.....................................................................................................................................81   Appendix A: Introductory Emails.................................................................................................92   Appendix B: Close-Ended Questions for Phase II Subjects.........................................................93   Appendix C: Interview Guides for Phase I & Phase II Subjects..................................................97   Appendix D: SOC Metric Results from the SOC-13 Scale..........................................................98  

iii Acknowledgements

First and foremost, I would like to thank the 70 subjects of this study who each volunteered more than an hour - and often several hours - of their time to this research project. Your accounts of healing from cancer are truly worth studying, and I was honored to document and analyze them to the best of my ability.

I would also like to thank my dissertation committee, including chair Lorraine Midanik for her unwavering support and guidance, and members Andrew Scharlach and Joan Bloom for their insightful comments and revisions. I would also like to thank Greg Merrill for his amazing mentorship and support while I attended UC Berkeley.

This dissertation research was supported by a Doctoral Level Training Grant in Oncology Social Work (DSW-07-228-01) from the American Cancer Society, by a Regents Intern Fellowship from UC Berkeley, and by a Dean’s Normative Time Fellowship from UC Berkeley. I will be forever grateful for this support; without it, this project would not have been possible.

Finally, I am blessed to have such supportive and encouraging family and friends. Thank you for helping me to see this project through to its completion. I would especially like to thank my partner in life and husband, Aaron Teich, for his constant support of this project - from beginning to end.

1 Introduction

Cancer is currently the second leading cause of death in the United States, second only to heart disease (Xu, Kochanek, Murphy, & Tejada-Vera, 2010). Although the progression of cancer is well understood, its exact causes and cure still elude researchers (Edwards et al., 2010). Current allopathic medical treatments of the disease include surgery, chemotherapy, radiation, and hormone therapy, although these treatments are only successful in achieving a 5-year survival rate approximately 68% of the time across all cancers (Jemal, Siegel, Xu, & Ward, 2010).

Spontaneous Remission (SR) of cancer, sometimes called Spontaneous Regression, is defined as “the disappearance, complete or incomplete, of cancer without medical treatment, or with treatment that is considered inadequate to produce the resulting disappearance of disease symptoms or tumor” (O’Regan, 1995, p. 2). SR is a rare but verified event, occurring in as few as one in one million cases for certain types of cancer, or in as many as one in four cases for other types of cancer (Kappauf, 2006; Seachrist, 1993). The causes of SR are currently not well understood by allopathic physicians, although some tentative hypotheses have been proposed. For example, some researchers have hypothesized that SR may be caused by a sudden surge of the immune system, which itself may be brought about by a high fever, bacterial infection, blood transfusion, minor or major surgery, or antibiotic usage (Fozza et al., 2004; Heibel et al., 2004; Maywald et al., 2004; Niakan, 1998, 1999). On the other end of the spectrum, some psychologists have hypothesized that SR can be caused by major psychological changes, such as a sudden shift in coping mechanisms, life purpose, existential thoughts, or sense of transcendence (Huebscher, 1992; Schilder, De Vries, Goodkin, & Antoni, 2004; Ventegodt, Morad, Hyam, & Merrick, 2004; Wagner, 1998).

Because of its rarity and current inexplicability, no clinical trials have yet been conducted on SR. Rather, the literature is comprised of over 600 individual case studies (e.g., Lee et al., 2008; Mulder, Rosenberg, Storm-Bogaard, & Koole, 2009; Yutaka, Omasa, Shikuma, Okuda, & Taki, 2009, etc.), numerous literature reviews (e.g., Abdelrazeq, 2007; Challis & Stam, 1990; Oquinena, Guillen-Grima, Inarrairaegui, Zozaya, & Sangro, 2009, etc.), and one notable annotated bibliography (O’Regan, 1995) . Despite this lack of clinical trials, the potential implications of studying SR are highly significant, because researching SR could lead to new insights into what causes cancer to grow or to remit. For example, if a physiological cause of cancer were to emerge from SR research, scientists would have a clear direction for developing novel pharmaceutical interventions for cancer. Alternatively, if a psychological cause of SR were to be uncovered through SR research, then medical social workers and psychologists would have a clearer direction for developing psychosocial interventions for cancer patients. Furthermore, if SR research were to reveal a healing mechanism that could be applied to other illnesses, the benefits of SR research would be even more far-reaching. Therefore, despite its rarity, SR is a worthy subject of research because of its potential impact.

The purpose of this exploratory study was to generate a wide range of theories for why SR of cancer occurs. This research goal was accomplished in two phases. In Phase I, three physicians and 47 alternative healers (n 1 =50) from the U.S. and ten other countries were interviewed about how their particular healing traditions describe cancer, its cause(s), and the

2 way(s) in which SR of cancer might occur. In Phase II, persons who experienced SR (n 2 =20) were interviewed about why they personally believe their SR occurred. In addition, after each Phase II interview, subjects were given a series of close-ended question to answer, as well as psychometric scale to complete. The close-ended questions collected demographic and descriptive information with the objective of further describing this unique sub-population in terms of psychological, medical, and social factors. The psychometric scale measured Phase II subjects’ “Sense of Coherence” (SOC) (Antonovsky, 1987), a coping attitude that has been previously associated with good physical health (Hart, Wilson, & Hittner, 2006; Read, Aunola, Feldt, Leinonen, & Ruoppila, 2005; Suominen, Helenius, Blomberg, Uutela, & Koskenvuo, 2001; Surtees, Wainwright, Luben, Khaw, & Day, 2003). Therefore, it was hypothesized that those subjects who have experienced SR would have a high score on the SOC scale as compared to general populations. Finally, in order to improve the validity of this study, Phase II subjects were given the option of allowing the Lead Investigator to verify their cancer diagnosis with their oncologists.

Specifically, this study addressed the following two research questions: 1. What causative theories do physicians, alternative healers, and SR survivors propose for SR? 2. Do persons who have experienced SR have a strong ‘Sense of Coherence’?

This study’s design was guided by Salutogenesis, a framework that encourages inquiry into why people become well, as opposed to why they become sick (Antonovsky, 1987). Furthermore, the research methods chosen for this study, namely semi-structured exploratory interviews, close-ended questions, and a psychometric scale, were deemed appropriate given the lack of knowledge currently surrounding SR. This study was considered a necessary first step in moving the field of SR research out of its current realm of individual case studies toward the goal of designing systematic research studies, which may have the ability to uncover more definitively the healing mechanism(s) behind SR. What follows is a literature review of Spontaneous Remission of cancer, a discussion of the theoretical framework that guided this research, a description of the methods used in this study, an explanation of the project’s findings, and finally a discussion of those findings.

3 Literature Review

This literature review describes the history of Spontaneous Remission (SR) research, the incidence of SR, reasons to study SR, physiological and psychological hypotheses for SR, the challenges currently facing the field of SR research, and the ways in which the current study addresses some of those challenges.

History of Spontaneous Remission (SR) Research The National Cancer Institute states that Spontaneous Remission (SR) of cancer, also called Spontaneous Regression, has been present for as long as cancer has been recognized as a disease (Seachrist, 1993). One of the first anecdotal cases of SR was of St. Peregrine’s famous bone tumor in the 13 th century, which protruded through his skin and was diagnosed by physicians as cancerous before it spontaneously healed following a night of intense prayer (Pack, 1967). Partially documented SR case reports first began appearing in the medical literature in the early 19 th century (Rohdenburg, 1918). In 1899, the first fully documented case report of SR was published in the medical journal Lancet (Bennett, 1899). This publication spurred an interest in SR and led to an increase in the submission and publication of SR case reports over the next decade. In 1906, at the first ever “International Conference on Cancer Research” held in Germany, a keynote lecture devoted entirely to the topic of SR was entitled, “Unexpected Recoveries from Cancer” (Czerny, 1907). During this lecture, oncologist and researcher Dr. Vincenz Czerny noted that SR often occurs after a surgical operation to de-bulk a tumor, and that the chances of a tumor experiencing a spontaneous regression may depend upon the tumor’s specific constitution (Kappauf, 2006) .

A decade later, in 1918, G. L. Rohdenberg (1918) published a collection of 302 potential SR cases, 70 of which he deemed to have sufficient medical documentation so as to be labeled definitively as initially malignant tumors that later spontaneously regressed. The remaining 232 cases still demonstrated SR, but lacked adequate documentation to rule out the possibility of initial misdiagnosis. It is interesting to note that among all 302 cases, the majority of the SR’s occurred either after a surgery to partially de-bulk a malignant tumor, or after an acute fever (Rohdenburg, 1918). Following Rohdenberg’s publication, case reports continued to appear in the literature over the next decade, and in 1927 the first case of SR of a neuroblastoma (cancerous brain tumor) was reported (Cushing & Wollbach, 1927). A year after this novel finding, the first case of SR of a lung metastasis (from a primary kidney cancer) was reported in the Journal of Urology (Bumpus, 1928); the SR of the metastasis occurred after the patient’s one malignant kidney was surgically removed.

Case reports continued to be published in medical journals over the next four decades until 1966, when the field of SR research experienced a turning point with the publication of two monographs devoted entirely to the topic of SR (Boyd, 1966; Everson & Cole, 1966). Everson and Cole’s (1966) systematic review of all published SR cases from 1900 to 1964 found 182 sufficiently documented cases of SR, according to the criteria that they set. The four most common types of cancer to spontaneously regress among these 176 cases were: 1) kidney cancer (renal cell carcinoma); 2) brain cancer (neuroblastoma); 3) uterine cancer (choriocarcinoma); and, 4) skin cancer (melanoma) (Everson & Cole, 1966). In their review, Everson & Cole (1966) also developed a standardized definition of SR, which they defined as “the partial or complete

4 disappearance of a malignant tumor in the absence of all treatment, or in the presence of therapy which is considered inadequate to exert significant influence on neoplastic disease” (p. 4). It is important to note that this definition does not require the regression to be permanent or complete. In other words, by choosing to use the phrase “partial or complete,” Everson & Cole implicitly included cases of SR where one, but not necessarily all tumors disappeared, or cases in which a metastasis disappeared, but the primary tumor did not. Their definition also implies that an SR may be temporary, followed by a relapse. Finally, it is also important to note that Everson and Cole (1966) decided to exclude SR cases of lymphoma or leukemia from their review, due to the natural fluctuations in the growth rates of these cancers; however, this decision was later reversed by subsequent reviewers.

Boyd’s (1966) monograph, published in the same year as Everson & Cole’s, was not a systematic review like Everson and Cole’s; rather, it simply contained 98 well-documented cases of SR that Boyd had selected from the literature as being prime examples of SR. Like Everson and Cole, Boyd also excluded SR cases of lymphoma and leukemia, again due to the natural fluctuations in their disease process. Interestingly, the two most common types of SR in Boyd’s monograph – retinoblastoma and breast cancer – were not among the four most common types of SR in Everson & Cole’s monograph. This difference emphasizes the importance of the selection criteria that one uses when determining which cases can be classified as SR cases.

After the publication of these two monographs, the number of published SR case reports doubled (Papac, 1996), implying that SR may have been occurring more frequently than had previously been presumed, and that physicians may not have been taking the time to submit official case reports to journals. In 1974, Everson & Cole hosted the first-ever conference on the topic of SR at Johns Hopkins University in Baltimore, MD (Proceedings of a conference held at the Johns Hopkins Medical Institutions, 1974). From 1974 until 1990, approximately 20 new SR case reports were published every year. Then in 1990, a systematic review was published that analyzed all cases of SR from 1900-1987 (Challis & Stam, 1990). Challis & Stam (1990) used the same definition set forth by Everson & Cole (1966), except that they chose to include SR cases of leukemia and lymphoma, thereby implicitly changing the wording of Everson & Cole’s (1966) definition of SR from ‘malignant tumor’ to ‘malignancy.’ Challis & Stam (1990) found what they deemed to be 489 sufficiently documented cases of SR. It is important to note, however, that only 123 of the 489 cases were leukemia or lymphoma cases, once again highlighting the power of selection and documentation criteria when determining which cases are sufficiently documented SR cases.

Then, in 1995, O’Regan (1995) performed an extensive search of the world literature, beginning with the earliest report of SR he could find up through 1990. According to his stricter documentation criteria, O’Regan (1995) determined that only 261 cases of SR were sufficiently documented, of which 30 were lymphoma or leukemia cases. The discrepancies in the total number of SR cases as determined by various reviewers will be discussed below in the section entitled, “Current Challenges.” O’Regan (1995) also formally redefined SR as follows:

“Spontaneous Remission is the disappearance, complete or incomplete, of cancer without medical treatment, or with treatment that is considered inadequate to produce the resulting disappearance of disease symptoms or tumor” (p. 2).

5

By choosing to use the word “cancer,” as opposed to Everson & Cole’s (1966) “malignant tumor” wording, O’Regan (1995) allows the term ‘Spontaneous Remission’ to include the unexplained disappearance, complete or incomplete, of 1) tumorous cancers; 2) non- tumorous cancers (e.g., leukemia); and, 3) metastases. In this author’s opinion, O’Regan’s new word choice is appropriate, because it correctly encompasses the three kinds of regressions that are being discussed currently in the SR literature. On a semantic note, however, SR researchers may want to consider replacing the words “disease symptoms” with “metastasis or non-tumorous malignancy,” so as to avoid the incorrect interpretation that SR may also include the unexplained disappearance of non-cancerous (albeit cancer-related) symptoms, such as fatigue, pain, etc.

More recently in the field of SR research, the second conference dedicated solely to the topic of SR was held in Heidelberg, Germany in 1997 (Proceedings of a Conference on Spontaneous Remissions in Cancer, 1997). In addition, approximately 20 new SR case reports are published in medical journals each year, and first-ever cases of SR are still appearing in the literature – such as Kappauf et al.’s (1997) publication of the first documented SR case of metastatic, non-small-cell lung cancer, or Isobe et al.’s (2009) publication of the first documented SR case of Natural Killer (NK) cell lymphoma. In summary, the history of SR research shows us that the field of SR research is still in its nascent phase, with only two conferences ever held on the subject, and with publications limited to case reports and literature reviews. However, the consistent frequency of case reports published annually shows us that SR is a persistent, albeit rare phenomenon. The following section will discuss the incidence rates of SR.

Incidence of Spontaneous Remission (SR) Across all types of cancer, Cole (1981) estimated that SR occurs in one out of every 60,000 to 100,000 cancer patients. Other researchers have proposed more conservative estimates, such as one out of every 140,000 cancer patients (Chang, 2000), while still others have argued that SR is more prevalent than the number of published case studies suggests (Kappauf, et al., 1997, O'Regan, 1995). Such under-reporting may be due to the fact that not all physicians take the time to write and submit potential SR cases to medical journals, especially if they have no hypotheses to offer as to why the SR occurred. Furthermore, because SR is, by definition, not the result of adequate medical treatment, there may be cases of SR that remain unknown to physicians, e.g., if the patient stops his/her medical treatment and later experiences SR.

In addition, some researchers hypothesize that SR (in the absence of any medical treatment) may be a natural course for cancer, albeit a rare one. However, because most cancer patients elect immediate allopathic treatment, it becomes impossible for researchers to determine whether or not the cancer would have remitted on its own, without the treatment. For example, prior to the development of the bone marrow transplant, most patients died from Acute Myeloid Leukemia (AML), although some SR cases were reported. Since the introduction of the bone marrow transplant, however, the number of SR cases of AML has diminished, presumably because most people with AML are now electing to have a bone marrow transplant, which makes it impossible to know how many of those cases would have remitted on their own (Maywald, et al., 2004).

6 Similarly, when Japan increased screening for cancerous brain tumors (neuroblastomas) in infants, the number of reported cases doubled (Seachrist, 1993). Those new cases may never have been brought to anyone’s attention without the additional screening; rather, the tumors may have spontaneously regressed on their own before the parents became aware of them (Seachrist, 1993). More recently, a longitudinal study in Norway compared one group of women who received three mammograms over a five year period to a control group of similarly-aged women who received only one mammogram at the end of the five year period (Zahl, Maehlen, & Welch, 2008). The cumulative incidence of breast cancer over the 5-year period was 22% higher in the screened group, which led the authors to hypothesize that the control group may have also developed breast cancer during that time, but that some of those tumors may have naturally regressed on their own, before the single mammogram was taken. Studies such as these suggest that one natural course of cancer may be that it occasionally regresses on its own, without any medical treatment. Nevertheless, this potential natural course of cancer is still very rare. The field of SR research would therefore benefit from trying to discover which kinds of tumors are likely to experience such natural regression, or under which conditions the tumors naturally regress.

In terms of SR incidence by type of cancer, Kappauf et al. (1997) notes that SR occurs in virtually every type of cancer. However, SR occurs more frequently in certain types of cancer and less frequently in others (Challis & Stam, 1990; Everson & Cole, 1966). General consensus among reviewers is that SR, whether temporary or permanent, occurs most frequently among the following five cancer types: skin cancer (malignant melanoma), kidney cancer (renal cell carcinoma), lymph cancer (low-grade non-Hodgkin’s lymphoma), blood cancer (chronic lymphocytic leukemia or CLL) and childhood brain cancer (infant neuroblastoma) (Chodorowski et al., 2007; Kappauf, 2006; Papac, 1998). For example, an astonishing one in four melanoma patients will experience at least a partial SR of their primary tumor (Seachrist, 1993), and it is estimated that one in ten renal cell carcinoma patients who have metastases in the lung only will experience SR (Gaussmann, Imhoff, Lambrecht, Menzel, & Mose, 2006). Similarly, because SR is so typical for a very specific kind of infant neuroblastoma (Stage IV-S), it is now standard medical practice to delay chemotherapy in those cases in order to see if the neuroblastoma will regress on its own, which it does 60-80% of the time (Seachrist, 1993). On the other end of the spectrum, cases of SR have been reported least frequently for some of today’s deadliest cancers, including lung, breast, colon, liver, and cervical cancer (O’Regan, 1995) . For these cancers, it is estimated that SR may occur in less than 1 in 1,000,000 cancer patients (Kappauf, 2006).

Reasons to Study Spontaneous Remission (SR) Although SR of cancer is a rare event, the fact that it occurs at all makes it a worthy subject of inquiry, because it shows that the human body is capable of controlling even very advanced cases of cancer (Papac, 1996). It necessarily follows, then, that one of the possible outcomes of studying SR is discovering a way to cure cancer (Papac, 1998), and perhaps to cure other diseases as well (O’Regan, 1995).

In addition to these noteworthy possible outcomes of studying SR, science also has a long history of learning from anomalous cases (Kuhn, 1962). In fact, SR research has already led to important discoveries about the nature of cancer. For example, when organ transplantation gained popularity in the 1970’s, some transplant patients developed lymphoma (cancer of the

7 lymph system). However, when these patients were taken off of their immuno-suppressant drugs (which were needed to keep their bodies from rejecting the transplanted organ), the lymphoma often spontaneously regressed, which led researchers to conclude that a suppressed immune system is less able to destroy cancer cells than a strong immune system is (Seachrist, 1993). In another example of how studying SR can lead to a greater understanding of cancer, a spontaneous regression of breast cancer that occurred after a female cancer patient went into menopause (i.e., experienced a decrease in hormones) led researchers to make a connection between hormones and breast cancer (Kappauf, 2006). Discovering this connection contributed to the development of today’s highly successful hormone-blocking treatments for certain breast cancers, such as the popular drug ‘Tamoxifen’ (Kappauf, 2006). Finally, the case of a metastatic gastric cancer patient who experienced SR after a surgery-induced bacterial infection (Rosenberg, Fox, & Churchill, 1972) has strongly contributed to the modern field of cancer immunotherapy, which injects small doses of bacteria into a tumor in order to stimulate the immune system to recognize and remove the tumor, as well as the bacteria (Rotrosen, Matthews, & Bluestone, 2002). These cases show that while the ultimate goal of SR research may be to uncover a cure for cancer, there are important lessons that SR research can teach us in the meantime about the nature of cancer cells.

Physiological Hypotheses of Spontaneous Remission (SR) Researchers and physicians have proposed both physiological and psychological hypotheses regarding the cause(s) of SR. In terms of the physiological hypotheses for SR, most researchers suggest that something causes the body’s immune system to surge and therefore dismantle the cancerous tumor and cells (Papac, 1996; Saleh et al., 2005; Seachrist, 1993). This makes sense in light of the fact that a typical person’s immune system detects and destroys approximately 400 cancer cells every day; therefore, the immune system is certainly capable of removing cancer cells from the body (Dzivenu & O'Donnell-Tormey, 2003). In some cases of SR, the SR is preceded by an extremely high fever, which some researchers suggest may be what causes the immune system to surge (Niakan, 1998; Seachrist, 1993). In other cases, the SR has been preceded by a bacterial infection that was treated with antibiotics (Maywald, et al., 2004; Nagorsen, Marincola, & Kaiser, 2002; Trof, Beishuizen, Wondergem, & Strack van Schijndel, 2007); in these cases, it is difficult to discern whether the presence of the bacterial infection itself stimulated the immune system, or whether the antibiotics were key in allowing the immune system to surge. A similar problem exists in cases where the SR was preceded by a blood transfusion (Kappauf, 2006; Maywald, et al., 2004); in such cases, it is difficult to discern whether the new blood supply simply strengthened the immune system, or whether the new blood contained some novel type of cell which allowed the immune system to recognize and dismantle the cancer.

In other cases, the SR is preceded by a biopsy or surgery on the tumor itself. In such cases, researchers hypothesize that the biopsy or surgery causes bleeding in the tumor, which activates the immune system to clot such bleeding, as the immune system would do for any other wound in the body (Heibel, et al., 2004; Kappauf, et al., 1997; O'Regan, 1995). This effectively sends a large number of immune cells rushing to the site of bleeding (i.e., the tumor), thereby changing the environment of immune cells around the tumor in such a way as to perhaps promote tumor regression (Heibel, et al., 2004; Kappauf, et al., 1997; O'Regan, 1995). Other physiological hypotheses for SR propose that an SR occurs when certain elements that are

8 necessary for a tumor’s survival are sharply reduced in the body. These elements may include: 1) a reduction in or blockage of blood supply to the tumor, e.g., due to a severe blood hemorrhage (Tocci, Conte, Guarascio, & Visco, 1990); 2) a reduction in the amount of lactic acid in the body (Niakan, 2001); or, 3) a reduction in blood glucose (Niakan, 1999).

Finally, some researchers have proposed that hormonal changes may elicit SR. For example, one published case (Antunez de Mayolo, Ahn, Temple, & Harrington, 1989) reported the SR of leukemia immediately after a woman gave birth, an event which obviously involves significant hormonal changes; however, three months later she presented with “massive, painful, leukemic infiltration of the breasts as initial manifestation of relapse, followed by systemic symptoms of leukemia” (p. 1621). The fact that her leukemia spontaneously regressed after childbirth – a hormonally-charged event – and then recurred first in her breasts – a highly hormone-sensitive organ – led the author of the case to hypothesize that large hormonal changes were somehow affecting the leukemia (Antunez de Mayolo, et al., 1989). Similarly, another researcher has hypothesized that a severe reduction in T3 (a thyroid hormone) may lead to the SR of lung cancer, and that reduced thyroid levels may be applicable to all types of cancer in terms of eliciting SR (Hercbergs, 1999).

Full document contains 105 pages
Abstract: Background. Spontaneous Remission (SR) of cancer is defined as "the disappearance, complete or incomplete, of cancer without medical treatment, or with treatment that is considered inadequate to produce the resulting disappearance of disease symptoms or tumor" (O'Regan, 1995, p. 2). Purpose. This study sought to answer two questions: (1) What causative theories do alternative healers, physicians, and SR survivors propose for SR?; and, (2) Do SR survivors have a strong Sense of Coherence (SOC)? Methods. Healers and physicians from 11 countries (n 1 =50) and SR survivors (n2 =20) were interviewed in-depth; 17 of the 20 cancer survivors also completed an SOC scale. Results. Six treatments that may elicit SR emerged frequently among both SR and Healer/Physician subjects: (1) Deepening one's spirituality; (2) Trusting in intuition regarding health decisions; (3) Releasing negative and/or repressed emotions; (4) Feeling love/joy/happiness; (5) Changing one's diet; and, (6) Taking herbal/vitamin supplements. In addition, three underlying theories about health emerged: (1) In order to remit cancer, one must change the underlying conditions that allow it to thrive; (2) Illness=Blockage/Slowness; Health=No Blockage/Movement; and, (3) A body-mind-spirit interaction exists. SOC scale results tentatively indicate that SR subjects may have a higher SOC than general populations, but not than other cancer survivors. Implications. Researchers are encouraged to use the results of this study to design research studies that assess the impact that these six treatments and three theories may have on cancer survival.