Notes from the Field: June, 2019
Nature Cure Clinical Pearls
Jared L. Zeff, ND, VNMI, LAc
The following is a not an article prepared for a medical journal. Not every statement of fact is cited or referenced. This is a commentary on the medicine, a running set of observations about practice in the field, not meant to be a peer-reviewed presentation. These are notes and thoughts from a practicing naturopathic physician, a primary care doc in general practice.
I truly enjoy practice. I have often stated, when asked, that my plans for retirement are to not retire. I intend to die at my desk, in my late 90s. At 72, my life’s work, this medicine, seems finally more comprehensible than mysterious, and I feel that, after 40 years in the field, I am starting to understand.
Each week I see a variety of patients with all manner of illness. I treat babies with fevers, children with ear infections, and adults with cancer, autoimmune disease, gastritis, hormonal disturbances, etc. Today I want to write about one of my most unusual recent cases – a 54-year-old man who came to see me last July complaining of a digestive problem, anxiety, and a golf-ball-sized lump in the axilla. The lump had been visualized on ultrasound, and a biopsy was pending. His digestive problems were characterized as gas, bloating, and pressure in the abdomen, with significant heartburn. He reported weight loss over the past year, from a somewhat excessive 146 lb to 109 lb, and holding at around 109. He stands 5 feet, 6 inches. He noticed the axillary lump in mid-January and presumed it was a lymph node. His conventional physician examined it in June and sent him for ultrasound. Eighteen years prior, he had a melanoma removed from his back, which was called stage 2 and was successfully treated. The axillary lump was hard, about 4 cm in diameter, roundish but somewhat irregular, tender, and sometimes painful. The biopsy was scheduled for the following week. I presumed it was malignant, probably a recurrence of the original melanoma of 18 years ago.
I developed a diet for him using old Dr Carroll’s method, which is designed to reduce inflammatory toxemia. I also instructed him in hydrotherapy to do at home, gave him a stomach tonic, and prepared a homeopathic medicine I use for post-surgical pain and healing: a combination of Arnica, Ledum, and Staphysagria, at a 200C potency.
I saw him 2 weeks later. The biopsy revealed a malignant melanoma, not dermal in origin (?), and unrelated to his original melanoma. The lump was more painful after the biopsy but responded well to the homeopathic medication I had given him. His wife was administering the hydrotherapy daily. He was eating lots of mushrooms, as I had suggested, following the diet I had recommended, and taking the bitter tonic. Since beginning the diet and taking the tonic, he was experiencing an improvement in the digestive symptoms, with no further heartburn.
I do not generally tell people to limit milk products or gluten unless I develop this information specifically for them, but in his case the Carroll method demonstrated a milk and gluten intolerance. Based upon his own research, he had added quercetin, 6000 iu vitamin D3, K7, vitamin C, zinc, selenium, biotin, ginger and turmeric, and alpha-lipoic acid. To this I added humic and fulvic acids – nutrient-rich soil components created by the degradation of organic matter by soil microbes and fungi, which act as natural chelators in the body, helping to remove toxins such as heavy metals; I have also found them useful in improving absorption of micronutrients. Additionally, I gave him modified citrus pectin and an old botanical anti-cancer alterative formula known as “Trifolium Compound.” I advised him against glutamine. I also referred him to a local oncologist.
The oncologist appointment did not go well. There was some glitch with his insurance, so the appointment was cancelled by the oncologist’s office. I referred him to a different oncologist, one with whom I had worked for over 20 years, and scheduled a return visit in 1 month, along with a weekly visit for hydrotherapy. I like to see these patients once a month for a re-exam.
On these monthly visits, I recorded a steady growth in the tumor mass, and then the appearance of a “lobule,” or second little mass, about 1 cm in diameter. My oncologist contacted the other oncologist, the local expert in melanoma, and they supposedly straightened out the problem. They had planned to give him a targeted antibody therapy as soon as the insurance was approved; however, the problem persisted, and conventional treatment was continually delayed.
As we continued, his weight stabilized, and his digestion improved. The bitter tonic was working well. This was old Doc Carroll’s “50 Formula”: half Gentian lutea and half Scutellaria (skullcap), taken in capsules with each meal. In October we added an extract of Viscum album (mistletoe), at 10 drops twice daily. By mid-December he was reporting less pain but ongoing fatigue. I had given him homeopathic Nitric acid 30C for the sharp, needle-like pain. This reduced the pain by half, but he required dosing several times daily. We added low-dose naltrexone (3 mg daily). In January we added berberine, at 3 capsules daily. I tried a series of Rife treatments, but probably overdid it because it exacerbated the pain around the tumor; as a result, he did not want to continue these treatments. In February he wanted to add Taraxacum (dandelion), based upon his continuing research, and I provided it in tincture form. He also noted a 3-pound weight gain. He had been holding steady at 109 lb since we started.
By April he reported that the pain was better with the Nitric acid. The tumor seemed to be a bit smaller, measuring about 3.5 cm in diameter. He had gained another pound. He wanted a mineral assessment, so we ran a hair mineral analysis, which showed low toxic minerals except for arsenic, which was in the cautionary “yellow” range; it also showed generally low nutrient minerals, suggesting malabsorption. I gave him Arsenicum 6C, to be taken once daily. I have found this to be an excellent way to remove heavy metals from the body, especially in combination with humic and fulvic acids. I also added betaine HCl to enhance mineral absorption.
By May he had gained another pound but was reporting frequent severe nausea. By this time, it was also clear that the “glitch” with the oncologist had not been overcome. I had spoken with the oncologist’s office several times, trying to facilitate a solution, and was always met with a kindly cheeriness, but they always reported that they were waiting on the insurance and seemed otherwise less that concerned about the time this was taking. He was content to continue working with me, and I was nervous. I wanted some objective measurement of progress. I began to research this, and found calcium-binding protein s100b, which has been used as a marker for treatment response and progression of melanoma. I ran the test on him, the result of which was 188 ng/L (normal range: 0-96). So, we had a marker to follow.
In June (last week, as of this writing), we noted a difference in the tumor. For the first time, this previously fixed lesion was motile and seemed clearly smaller. The “lobule” was gone as well, leaving a distinct single lesion – still hard but less tender. His weight was up a bit more, and there was clearly more flesh in his face, which had always appeared as somewhat dark and sunken. His color had improved, as well as his energy. I reiterated our initial discussion about the potential for a healing reaction, and warned that if any fever developed, it must, under no circumstance, be interfered with. If fever did develop, I advised him to let me know immediately and to remain in daily contact.
This is where we are in this case. I will report further on the case as new information develops. But I want to end this “note” with a discussion about healing reactions.
A classic healing reaction generally goes like this: The patient slowly gets better and better, usually in an intermittent fashion, then starts to feel really good, then suddenly gets a “flu,” feels horrible, feverish, has some kind of discharge, and then recovers, along with a resolution of the original complaints. When this occurs, I want to examine the patient to see whether I can, in some objective fashion, determine whether this is indeed a healing reaction, or something else. I look for “core” improvement, following Hering’s guidance: healing from more important toward less important organs, healing from the inside out, top down, and in reverse order of the acquisition of symptoms. So I listen to the heart, check the lungs and vital functions, and generally question the patient in detail about symptoms. Again, if a healing reaction is occurring, it is imperative that the fever not be interfered with. It IS the healing reaction. A simple baby aspirin is enough to reverse the process, eliminate any possibility of further healing, and result in the return of the cancer to its lethal progression.
I am hoping we see something like this in the melanoma patient.
A final word about this case… A bit more than 20 years ago, 1996 if I recall, I put together the first naturopathic cancer conference; as least I think it was the first one. I called every doctor (naturopathic) I could find or hear of who was treating cancer, and invited them to come to Portland for a weekend conference at a local hotel. There were 21 attendees, who came from around the United States and Canada, and the whole thing was professionally recorded on cassette tape. I wanted to hear what everyone was doing because I did not want to miss anything important. I wanted to be sure I was doing everything I could for these patients.
I had been having good success with all manner of chronic disease, using the old methods I had learned from my mentor, Harold Dick, ND, of Spokane, WA – he himself a protégé of old Doctor Otis Carroll. Carroll was an early student and colleague of Lindlahr and Lust. I wanted to know whether I could successfully treat cancer patients using these fundamental methods.
My teacher, Dr Dick, had told me that there were no incurable diseases, though there were incurable patients. As I began to wonder about success with cancer, I began to see more cancer patients. They just showed up. I think this is how the universe works. Shortly after forming this “intention,” about 80% of my patients had become people with cancer. I treated them with the fundamentals of this specific dietary work, daily constitutional hydrotherapy, botanical medicine as indicated, homeopathy specific to their case, and whichever supplements seemed indicated. Some were being conventionally treated; a few were seeing only me. These ones did the best, and I had a number of cures – real cures – using only these fundamental naturopathic methods. Once I was satisfied that these old fundamentals could reverse cancer, my patient load began to shift and my cancer patients reduced to around 15-20% of my practice, replaced by the other chronic diseases.
Cancer is a difficult problem. It has implications way beyond the usual chronic diseases, including political and economic. It is, by nature, a mortal diagnosis, and is often a cause of death. Children have been removed from their parents’ care if the parents even hesitated to utilize conventional treatment. Many of us are afraid to treat these patients, and we have developed a specialty association – the OncANP – composed of those docs who want to focus primarily on these patients. These days I often refer cancer patients to these FABNO-designated colleagues.
I do not know what is going to happen with this melanoma patient. This is an odd situation to be waiting, as if for Godot, for the oncologist to see this person and to be “standing in,” so to speak, providing care as best I can until the -ib, or the -mib, or the -mab, or whatever, can be started through the conventional system; these treatments are, of course, beyond the financial reach of the average person. So, I will continue to apply my skills, such as they are, and follow this case while we wait. In 2 months, I plan to repeat the s100b protein test as an objective marker of progress, and we will see what happens.
I am certainly open to comments, questions, and criticisms.
Jared L. Zeff, ND, VNMI, LAc
Jared L. Zeff, ND, VNMI, LAc, is a licensed doctor of naturopathic medicine and a licensed acupuncturist. In addition to functioning as Medical Director at the Salmon Creek Naturopathic Clinic in Vancouver, WA, Dr Zeff teaches on the faculty at National University of Natural Medicine in Portland, OR, where he was also Dean from 1988 to 1993, and holds a professorship in Naturopathic Medicine. Dr Zeff is a graduate of the University of California, NCNM, and the Emperor’s College of Traditional Oriental Medicine. He, along with Pamela Snider, is the author of the AANP’s Definition of Naturopathic Medicine, and the Therapeutic Order concept.