Cancer and survivorship
I HAVE never written a letter to the editor before, but I am in such vehement disagreement with the point of view expressed by Dr. Darshak Sanghavi in his March 30 op-ed "Keeping cancer real" that I felt it was my civic obligation.
Some years back I worked for the Hippocrates Health Institute, which attracted cancer patients after Western allopathic medicine had informed them they were terminal, and I saw a few get well. This inspired me to 20 years of study on miracle healing.
Western medicine disempowers cancer patients, because it bases its predictions on statistics. Statistics dismiss those few who don't fall within the curve as insignificant. But my work has shown that these outliers had special qualities that are important for every cancer patient to adopt for themselves .
Does Dr. Sanghavi not know about scientific studies showing that fear and despair turn into neuropeptides, which lock onto cellular receptors in the immune system and shut it down? Attitudes of hopelessness such as he expresses are doing the cancer patients of the world a great disservice.
As Brendan O'Regan of the Institute of Noetic Sciences has said, the problem is not one of offering false hope, but of offering false despair.
BARRY HARRIS
Brookline
IN OUR society's desire to put a positive spin on every negative, we are in great danger of underestimating the potential of what Dr. Sanghavi rightly calls the "extraordinary biological sadness" of cancer, and of reducing it to a support group, a walkathon, or a colorful ribbon .
My heart goes out to Tony Snow and Elizabeth Edwards, but they -- and we -- are in denial if they think that the recurrence of their cancers will not profoundly affect their lives.
A positive attitude makes cancer treatment easier for the patient, the family, and the medical team, but it does not guarantee a long and healthy life, and patients should be permitted to express fear, anger, and other negative emotions without fear of criticism. Dr. Sanghavi's is one of the first voices I've heard that approaches this tragedy realistically, and as a breast cancer survivor, I thank him.
KATHRYN RUTH BLOOM
Boston
DR. SANGHAVI'S op-ed is bound to provoke a certain amount of criticism for its hard-headed, seemingly hope-denying tone. As a survivor of a deadly, "presumptively metastatic" cancer, I'm willing to bet little of this criticism comes from my survivor peers.
The term "survivor" is itself misleading. The National Cancer Institute defines it as "one who remains alive and continues to function after overcoming difficulties or life-threatening diseases like cancer." The American Cancer Society defines it more loosely, to include "anyone who has been diagnosed with cancer" and who is still alive. The common concept is the lack of a promise of permanency. Cancer can always come back.
For those of us who live with the knowledge that our cancers are likely to eventually kill us, Dr. Sanghavi's words are a breath of fresh air.
WALTER W. CROW
Scituate
DR. SANGHAVI reminds us of the importance of maintaining an appropriate perspective in keeping alive the hopes of cancer patients for a normal life and a cure. And it reminds us of the thirst for more progress in cancer research. However, readers may be misled into believing that cancer, once spread to other sites by the bloodstream , is incurable. Or that advances in surgery, chemotherapy, and radiotherapy provide "abstract comfort" but have produced few cures in patients with blood-borne metastases. Or that research has been largely unsuccessful in efforts to stop the "inexorable advance" of cancer. Or that the fate of an individual with metastatic cancer is sealed.
As a surgeon, I have patients who had "incurable" metastases from colon cancer who are cancer-free over a decade after surgical removal of their blood-borne metastases. As an oncologist, I have patients who had "incurable" metastases who remain cancer-free after chemotherapy . As a cancer researcher, I have patients in whom an experimental approach of radiofrequency ablation completely destroyed their "incurable" liver metastases from breast cancer . My own experiences are no different from those of legions of other oncologists.
Dr. KENNETH K. TANABE
Chief of surgical oncology
Massachusetts General Hospital Cancer Center
Brookline 
