TANSTAAFL, or There Ain’t No Such Thing as a Free Lunch!

Robert Heinlein got it right.  In “The Moon is A Harsh Mistress”, sometime in the future, we colonize the moon.   But we don’t send our best and brightest, we send our criminals, our misfits, our dregs of society.  They eke out a hard living in this future penal colony:  their language becomes muted, shortened;  their luxuries are in short supply.  They learn lessons about survival early and often and they become a tough, spare people whose motto is “There ain’t no such thing as a free lunch!”

It is a great misfortune that this axiom is true in cancer treatment as well.  Sometimes patients come to me too late.  They have been seeking the path to a cure elsewhere, and in this part of the country elsewhere is many times across the border, where all manner of crooks and quacks (and as my Yiddish speaking grandmother would say, “SHEISTERS!”) have set up shop to convince patients with dread diseases that THEY alone have the cure. The first wave of so called “alternative” cancer treatments came in the 80’s with laetrile, distilled from the pits of apricots and peaches.  This was followed by a whole load of so-called “cleansers”, some of which involved putting some pretty disgusting substances into orifices that should have been on the giving and not the receiving end of the body (coffee ground enemas, anybody? Anybody?)  From the macrobiotic diet, to the wheat grass cures, to the more expensive and extremely dangerous Insulin Potentiation Therapy which killed Coretta Scott King, patients come in droves to line up for any “cure” but standard of care curative treatment. Scott King, Martin Luther King’s widow,  died a miserable death at the Clinico Santo Tomas, which was not legally licensed to perform surgery, take X-rays, run a laboratory, or dispense drugs from a pharmacy, all of which it was doing until an investigation after her death shut them down.  Patients will go to great expense and travel extraordinary distances from their homes to line the pockets of snake oil salesman.

Why do they do this?  They do this because they are so frightened of conventional surgery, chemotherapy and radiation, that they will do ANYTHING to avoid the purported side effects of such treatment.  I say “purported” because the reality of standard cancer treatments is often times far less toxic than what lies in the imagination.  Friends and relatives are often less than helpful, even though they are usually well meaning.  Trust me, there is no vitamin you can take, or juice you can drink, or special berry that you can put where the sun doesn’t shine that will cure you. Conventional treatments have side effects, but they also CURE cancer.

We’ve made great progress in the 30 years that I’ve been a radiation oncologist by reducing normal tissue doses, increasing shielding ability, shaping more precise radiation beams, and my medical oncology colleagues have done the same, with targeted disease specific drugs rather than the old “shot gun” approach.  But if you think that it is possible to cure cancer without risk, side effects and yes, even potential harm, think again.

In cancer, in life:  There Ain’t No Such Thing as a Free Lunch!