Abraham Cherrix: Still battling Hodgkin’s lymphoma five years later

When you’ve been at this blogging thing as long as I have, it’s possible to be shocked at how long you find yourself commenting on the same story. As I approach the end of the seventh year of Insolence, both Respectful and not-so-Respectful, I find these “senior blogging moments” popping up from time to time. One such story is that of a young man named Abraham Cherrix. I first learned of Cherrix back in June 2006, when, a few months after having been diagnosed with Hodgkin’s lymphoma at age 15, Cherrix, supported by his mother, decided that he didn’t want to take any more chemotherapy and simply refused. His choice as an “alternative” therapy was a doozy, too, pure quackery. Instead of science-based medicine, Cherrix decided he wanted to undertake Hoxsey therapy, involving involves herbal concoctions popularized by Harry Hoxsey. Different varieties of this therapy exist, but they all trace their roots back to 1840 to Harry Hoxsey, who claimed that the formula had been passed down from his great-grandfather John Hoxsey to his grandfather to his father to him. The story claimed that John Hoxsey had mixed together grasses and flowering wild plants growing in a pasture where one of John Hoxsey’s horses grazed daily. The horse supposedly had a cancerous growth that went away, and Hoxsey thought that it was due to the plants upon which the horse grazed. He took plants from the pasture, mixed them together, added some ingredients for home remedies for cancer at the time, and–voilà!–he had what he thought was a cure for cancer. It’s a “cure” that is being hawked at quack clinics in Tijuana.

Cherrix and his parents ultimately were forced to go to court, where initially the judge ordered that the boy undergo chemotherapy. Throughout the “acute phase” of the Abraham Cherrix story, the issues raised included the question of how old a child must be before he can make his own health decisions and understand the consequences of choosing quackery over science-based medicine, particularly given the magical thinking about lymphoma that Abraham exhibited at many points during his odyssey. Indeed, it was Abraham Cherrix who, it might be said, “inspired” my post about chemotherapy versus death from cancer. Ultimately, a compromise was arrived at whereby, until he turned 18, Cherrix could pursue his woo but agreed to go to a woo-loving radiation oncologist for “spot” radiation therapy to the various lymphoma tumors plus a highly dubious-sounding form of “immunotherapy.”

In the end, Cherrix did surprisingly well, having probably had a fairly indolent form of Hodgkin’s disease. When last I wrote about him, Cherrix was parlaying his 15 minutes of fame into a speaking tour of medical schools, where he told his story and promoted his quackery. At the time, he spoke of using “detox foot baths” and how he wanted to become a naturopath. That was three years ago. This is now:

He’s also still battling Hodgkin’s disease, which he was diagnosed with in 2005 at the age of 15. Now, though, he’s fighting it away from news cameras, and outside the venue of the Accomack County Courthouse.

But he is still fighting it.

Since the court battle wrapped up in August 2006, he’s been through four different rounds of radiation to eradicate tumors, and even consented to a round of chemotherapy — his stubborn refusal of that treatment landed him and his family in court in the first place.

It’s rather interesting how in the past Cherrix liked to represent his battle against cancer as being won largely with “nontoxic” and “natural” therapies, just supplemented with a little bit of radiation administered by Dr. R. Arnold Smith. At the time, I pointed out that lymphoma is a systemic disease. Given that the “immunotherapy” that Dr. Smith promotes is pretty much worthless, that means that Cherrix has simply been treated with radiation over the last five years. Each time new tumors pop up, he gets them radiated, and the disease is in check for a while. While this approach is highly effective in the short term, it’s a strategy of diminishing returns. The radiation dose administered to normal tissue is cumulative and permanent. There is a limit to the amount of radiation normal tissue can tolerate. The problem with the approach that Cherrix is taking is that it’s quite similar to playing Whac-A-Mole. More importantly, sooner or later, tumors will recur in parts of the body that have already had their maximum safe exposure to radiation. When that happens, no more radiation can be given. As has been discussed before, in failing to eradicate the tumor when it was diagnosed, Cherrix has chosen a course doomed to ultimate failure, although certainly the process can be dragged out for quite some time.

Unfortunately, as much as I had hoped that Cherrix would have matured by age 20, apparently he has not. He’s still just as stubborn and unyielding as he was when he was 15; only now he’s running out of options:

The next year [2010], he felt a small raised spot on the left side of his chest. He ignored it.

“I had this idea of, ‘Yes, I’m done with cancer.’ I was in denial. I didn’t want to entertain the thought that it might be back. It’s annoying. You want to stop eventually. I was trying a new experiment of, ‘If I think positive, what effect will that have on my body?’ “

Whatever effect thinking positive had on Cherrix’s body, it didn’t stop his lymphoma from popping back up again last year. In fact, in this very same article, bioethicist Art Caplan put it quite succinctly by saying that “cancer kills people who think positively as well as those who think negatively.” Certainly thinking positively didn’t stop this:

But by summer, he was coughing up blood. Rose took him to a hospital in nearby Radford. An X-ray showed a tumor in his lung that was pressing against a blood vessel.

“It scared me. Subconsciously, I knew what it was.”

They wanted him to have a lung biopsy. Abraham, though, wanted to go back to see Dr. Smith in Mississippi.

He was told if he left it would be against doctor advice, because the vessel could burst at any moment. Also, if he left against doctor advice, he would likely have a hard time getting insurance to cover his treatment out of state.

Fortunately, Dr. Smith was able to eradicate this latest tumor with six weeks of what is described as low dose radiation treatment that ended early this year, and, as the article points out, there are parts of Cherrix’s body that can’t take any more radiation, such as the area around the spinal cord. Basically, if he gets another tumor that might impinge on his spinal cord, he’s screwed, as in he’ll be paralyzed at the level the tumor compresses his spinal cord. It’s possible that surgery might delay the process, but in general spine surgeons tend to be very reluctant to operate on cancer compressing the spinal cord because the chances of complications are high if the area being operated on has been radiated before. Loosing control on one’s bowel and bladder followed by ultimately losing control of the lower extremities is not fun, but it’s certainly a possible fate that Cherrix faces.

In fact, this article even addresses that very question, with the reporter asking Wilson Gaillard, the administrator at Dr. Smith’s clinic point-blank, what would happen if a tumor popped up in an area that could no longer be radiated. His answer was hardly reassuring:

“We’ll have to reach into our bag of tricks,” Gaillard said. “Some treatments are more effective than others, but there are still options. We are keeping our fingers crossed and hoping we won’t see him again.”

I’ll bet they are. Even Dr. Smith must realize that his “immunotherapy” didn’t work, and that if Cherrix shows up again at his Mississippi clinic he’ll have precious little to offer him. Unfortunately, Abraham is not so realistic:

Abraham said that even if another tumor arises in a place where he can’t use radiation again, there are more options out there, including the one he wanted to try in the first place, the Hoxsey method.

“It was working,” he said.

Actually, no it wasn’t. If it were, he wouldn’t have needed radiation, even the suboptimal regimen administered by Dr. Smith. But Hoxsey therapy isn’t the only woo that Cherrix would try:

“There’s dozens of things,” he said before launching into a discussion about medicinal mushrooms and the “Rife Ray Machine.” Both are alternative methods that have been denounced by the medical establishment. Alternative medicine websites, though, tout them as methods “the medical Mafia” wants to keep under wraps.

Ah, yes. Shades of Kevin Trudeau again! Alternative cancer cures “they” (whoever “they” are) don’t want you to know about.

I’ll be the first to admit that Cherrix has done better than I predicted for longer than I predicted. However, it should not be forgotten that he’s had multiple recurrences, requiring multiple courses of radiation therapy to different parts of his body. It also shouldn’t be forgotten that he’s running out of options as far as radiation goes, having maxed out areas of his body, such as around the spinal cord, on radiation such that he can’t have any more there. In fact, I’m not even sure that I buy that he’s in remission right now, given how Gaillard described Cherrix’s tumor markers as indicating he’s in remission but characterized his tumors themselves as having “diminished.” Not “disappeared,” but diminished, which implies that they’re still there, in which case Cherrix is not in remission. This well might be the case, given that Cherrix’s most recent course of radiation was described as “low dose,” which suggests a dose inadequate to eliminate the tumors. Certainly, it’s possible that Cherrix is currently in remission, but I doubt it.

Unfortunately, what I see is a young man who appears to be slowly approaching the end of the line. What saddens me is that it didn’t have to be this way; Cherrix’s lymphoma was highly curable with radiation and chemotherapy when he was diagnosed. If he had followed the standard of care, his chances of long term survival would have been excellent. He didn’t, and now he’s running out of options. It’s not even clear to me that, if he changed his mind suddenly and decided to go all out with everything science-based medicine has to offer, it’s not already too late. I hope it isn’t, and I hope Cherrix changes his mind, in case it isn’t too late.