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Thursday, October 6, 2022
Dr. Brown: Indeed, miraculous medical recoveries do happen

When I was a medical student, the dean of Medicine at Western University presented the history of a young man who had a malignant melanoma with metastases to his liver (based on a laparoscopic biopsy) and lungs (based on chest X-rays).

He was rapidly losing weight, and in those days, little could be done and there was every expectation the patient would not survive long. But because he developed severe anemia, he was given blood transfusions.

And to everyone’s surprise, he began to recover. Within a few months he felt better, regained weight, evidence of the metastatic lesions in his lungs resolved and he returned to work.

The dean, who looked after him when he was on staff at the Princess Margaret Hospital, was stunned as was everyone else familiar with the case and speculated this might be a rare example of spontaneous remission, with a query about the role the transfusions might have played in his recovery.

Like the preceding case, half a century ago there wasn’t much that could be done for most heart diseases, strokes and cancers. But in the last 50 years there have been major advances in the prevention and management of all three – and what might have been considered miraculous recoveries in earlier times occur more often these days.

One example of thiis was John, a middle-aged man, who was found to have a late-stage cancer, which initially was considered too advanced to do much about because the cancer had spread to his liver and bones.

Then for John, and to some extent his physicians, the unexpected happened: a combination of checkpoint inhibitor drugs and radiation turned around what looked like a hopeless situation. Several months later all trace of the original cancer was gone and remained so thereafter.

Was that a miracle? For his wife, it was an answer to her prayers. For his part, John was content to attribute his good fortune to the miraculous action of the checkpoint inhibitor drugs and the physicians in the cancer clinic who suggested their use.

A similar spectacular outcome for late-stage cancer famously occurred with former U.S. President Jimmy Carter whose malignant melanoma had spread to several organs, including the brain, but resolved following treatment with immunotherapeutic drugs similar to John’s. And for that family of drugs, Tasuku Honjo of Japan and James Allison from the United States, were awarded a Nobel prize in 2018.

Sometimes healings are stunning, even if bewildering. In my career I have looked after many patients who suffered from intractable pain, severe enough to take opiates and other pain medications and seek the help of experts in London, Ont., Toronto, Boston, Hamilton and the Mayo Clinic.

Two cases stand out. One was forced to give up her job as a custodian for a high school because of the severity of the pain in her lower back and legs. A friend suggested that she seek out a faith healer in Quebec.

Within days of seeing her, the pain began to improve to the point that within several weeks she was off all her pain medications and, shortly thereafter, was able to return to work only to have the pain return in about a year.

Like the first time, after a return visit to the same faith healer, the pain resolved again for several months, and I lost further contact with her.

The other case involved a man suffering from what was called trigeminal neuralgia for which he had been treated with a variety of epilepsy and pain medications, to little effect except to make him groggy and unsteady.

In a nearby Indigenous community there was a teenage girl who was reputed by band members to possess healing powers through her touch. When she touched the painful side of his face, almost immediately the pain began to improve and he, like the woman who saw the faith healer, was able to stop his medications and return to work.

And like her, his symptoms recurred several months later. Unfortunately this time, the girl who “cured” him the first time around, had moved on and band members were unable to locate her. The resolution of the pain was dramatic in both cases and begs the question: What explains the resolution of the pain and for so long?

Each of the cases had what might be called a miraculous outcome and while the actions of checkpoint inhibitors are understood, spontaneous resolution of a malignant cancer and faith healer-induced resolutions of pain are much harder to explain.

It’s a subject worth exploring in the autumn Infohealth series and a reminder, if we need reminding, that physicians don’t always have answers and there’s more mystery than many might be ready to admit.

Dr. William Brown is a professor of neurology at McMaster University and co-founder of the Infohealth series at the Niagara-on-the-Lake Public Library.