Hypothesis. The importance of a histological diagnosis when diagnosing and treating advanced cancer. Famous patient recovery may not have been from metastatic disease

Abstract

Over the past 33 years, mystery has surrounded the diagnosis and treatment of a very influential Australian patient. In the long gap between amputation of his leg for osteogenic sarcoma and successful treatment for widespread tuberculosis, he was told he had advanced and incurable metastatic sarcoma. Details of his recovery and the treatments used have been extensively described. An alternative hypothesis is advanced to explain his recovery. This hypothesis is advanced for two reasons. The first is to underline the modern recognition of the need to consider diagnostic investigations, including biopsy, before assigning the diagnosis of advanced cancer to any patient. This principle is especially vital in cases where two diseases can present in the same way. The second is that there a risk that if diseases are incorrectly labelled, incorrect treatments may be given. This can lead to misleading interpretations being made about non-traditional treatments providing 'cures', which can influence the decision-making of patients seeking answers and even lead them away from potentially curative traditional treatments.

Timeline errors undermine hypothesis; ‘famous patient’ did have secondary osteogenic sarcoma and tuberculosis

“…I am ‘the famous patient’ discussed by Haines and Lowenthal 1 in a hypothesis that despite my refusal to agree to publication has appeared in the Internal Medicine Journal . I am disturbed that the Journal would agree to publish this speculative report without permission of the patient (myself).…”

Mycobacterium mimicking metastatic melanoma

“…There are numerous cases in the literature where mycobacterial infections mimic malignancy, including patients presenting with solitary lung nodules, breast lesions, bone lesions and disseminated disease . In recent years it has come to light that a prominent Australian championing diet and intensive meditation as a cure for metastatic osteogenic sarcoma may have had disseminated tuberculosis rather than metastatic disease, having survived 37 years after the diagnosis of secondaries from sarcoma . We report three cases where, based on the clinical picture and radiological findings, atypical non‐tuberculous mycobacterial infections were mistaken for metastatic melanoma.…”

The importance of a histological diagnosis . . .

“…I am a Melbourne GP and a contemporary of Ian Gawler. I read with great interest the article you published recently by Haines and Lowenthal 1 . My interest comes from having been a believer in and supporter of Ian Gawler ever since reading his first book You Can Conquer Cancer not long after it was published a good many years ago.…”