A survivor he is – no doubt about that as I was his 24-7 caregiver and saw him go through an horrendous experience. But what was his diagnosis? Was there a biopsy that proved a diagnosis of secondary cancer? No, there was no biopsy? Were his symptoms typical of secondary bone cancer? No they were not typical. YES he is a survivor, but a survivor of cancer or tuberculosis that mimicked cancer?
Is this important? YES! The truth and disclosure in this matter is imperative in the public interest!
Why? Because every cancer patient who read’s Ian’s book – the original written long before his remission came into question; says well if Ian did it i.e. recovered from advanced cancer, then I can do it too.
With new understanding and recent evidence disclosed in the public arena; the latest paper by IMJ 2012 Haines and Lowenthal published in the IMJ (Internal Medicine Journal 2012) presents a well constructed scientific paper that assesses Ian Gawler’s symptoms and developments from 1974 onwards; concluding that he had advanced tuberculosis that mimicked osteogenic sarcoma. The report (link above) does it discredit Ian nor does it criticize his work with patients in stress reduction and lifestyle approaches to well-being…..but importantly what it does is to inform cancer patients that his secondary cancer was highly likely to have been a misdiagnosis!
Relevant Medical Journal Links in Chronological Order:
1. PDF of Ainslie Meares 1978 Medical Journal abstract – the uncorrected mistake that started it all – Meares. A. MJA 1978
Comment: Flawed information in this abtract (not peer reviewed) implies that Regression of Ian Gawler’s ‘cancer’ was “Associated with intensive meditation.” Chronology incorrect – very significantly, the timeline had been ‘adjusted’ resulting in a 19 month discrepancy which implies gross disease (at this time) when it was only minimal.
2. Dr Ruth Gawler and Prof G Jelinek’s Dec 11 2008 Medical Journal Report MJA True Stories
Comment: Dr ruth Gawler & Prof G Jelinek’s report is even more heavily flawed. It repeats Meares error, introduces unsubstantiated and irrelevant theories, has many incorrect chronologies & dates, photo date altered by deleting original date from 7 July 1977 stating they were taken in 1976 (proof available) – medical history vague, states Ian Gawler followed a vegan diet and implies that is also part likely for his ‘cure’ (NB Ian Gawler never had a vegan diet).
It states Gawler developed TB in 1978 – whereas – retrospectively, xrays demonstrate he had it for more than 2 years un-diagnosed. Published as a True Story: Peer reviewed – by Dr Sandra Neate (Neate was married to Pfor Jelinek and was a personal friend of Ian & Ruth Gawler) – no conflict of interest was ever declared. This is highly irregular!
3. My MJA letter & corrections – 20 September 2010. http://www.mja.com.au/public/issues/193_06_200910/letters_200910_fm-1.html Cancer patients at risk from inaccurate clinical reporting in a high-profile alternative treatment story: comments and corrections
My corrections of the chronological errors – fact checked by MJA – based mainly on past Gawler articles. Corrected photo dates and other in the 2008 Gawler Jelinek MJA.
Note: Both MJA reports 1978, 2008 had been on Gawler website for 2 years AND… have remained on the Gawler website since that time despite Ian admitting the Meares timeline error and that he never followed a vegan diet. Important ?? Absolutely.
4. Prof Ray Lowenthal and Prof Ian Haines IMJ abstract.
“The importance of a histological diagnosis when diagnosing and treating advanced cancer. Famous patient recovery may not have been from metastatic disease”
Over the last 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.
1. 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.
2. The second is that there is 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.
5. 21 May 2012 Healed or Hungry Gawler perspective (Hall, MJA 2012)writes in the Medical Journal of Australia (MJA) about the Gawler Program
6. June 9 2012 Doctor denounces Gawler program June 9 2012 Julia Medew Melbourne Age– Age Medical writer Julia Medew reviews the Tanya Hall comments in MJA
7. Censorship The MJA and Gawler Emma S McBryde questions why an important scientific paper about Ian Gawler’s TB was rejected by the MJA – Med J Aust 2012; 196 (10): 628.
Conclusion by Meares: MJA October 1978
It would seem that the patient has let the effects of the intense and prolonged meditation enter into his whole experience of life. His extraordinarily low level of anxiety is obvious to the most casual observer. lt is suggested that this has enhanced the activity of his immune system by reducing his level of cortisone. (Note: when he wrote this Meares did not know the patient had Tuberculosis for 2+ years)
Conclusion by Gawler & Jelinek – Dec 11 2008 MJA
Meares and the patient attributed the remarkable recovery to intensive meditation, and it is true that the patient meditated from 3 to 5 hours daily after developing secondaries. He still regularly meditates and teaches others with cancer to do so. His fastidious adoption of the Gerson diet 10 for 3 months, followed by adherence to a plant-based wholefood vegan diet may also have played some part. Such a lifestyle approach, incorporating meditation and a vegan diet, has recently been shown to cause significant modulation of gene expression and biological processes associated with tumour growth.
Conclusion by Grace O Gawler corrections MJA Sept 20 2010
Teasing apart the errors in Jelinek and Gawler story, now on the public record and almost medical myth, is an enormous task, but one that must be done, because correctly reporting the patients clinical timeline is crucial in any discussion about the causes of his remission and the flow on effect to cancer patients and their treating doctors.
Conclusion by Haines and Lowenthal IMJ Jan-Feb 2012
We especially note the psychological resilience that enabled him to overcome the dire prognosis he was given that fortunately turned out to be inaccurate.
Nonetheless, there is an aphorism, attributed to the late Carl Sagan, that exceptional claims require exceptional evidence. We contend that unequivocal evidence that the patient was cured of widespread metastases is lacking, and that the unusual treatments that were employed in this case cannot be held out as an example of a path to be followed by other patients with metastatic cancer.
What do you think?
Due to many inconsistencies and misleading information that was causing cancer patients to follow vegan diets and pursue long hours of meditation in the hope of emulating Ian Gawler’s recovery process, I regard my MJA letter to the MJA as a duty of care and responsibility to alert cancer patients.
To the Editor: I would like to correct some inaccuracies in an article by Jelinek and Gawler in the December 2008 issue of the Journal about a survivor of disseminated osteosarcoma.1
The article describes a 58-year-old man who was diagnosed in 1974, at the age of 24 years, with histologically confirmed high-grade osteosarcoma of the right femur. He underwent a full leg amputation in January 1975, but metastases recurred 11 months later, in December 1975.
The authors of the article misreported a sequence of medically significant events, altering the patient’s actual history. (The correct chronology and early clinical history of the case have been published elsewhere.2,3)
The errors and omissions in the article by Jelinek and Gawler, together with the correct sequence of events and relevant inclusions, are outlined in Box 1. In summary, the major errors in the article were as follows:
- Timeline errors. The authors stated that the patient first saw Dr Meares in September 1976, after chemotherapy had failed. In fact, the patient consulted Meares as a first-line treatment approach on 12 December 1975, and did not consider chemotherapeutic options until September 1976. The authors also stated that the patient had palliative radiotherapy in September 1976. In fact, the patient had only one course of palliative radiotherapy treatment, in February 1976.
- Vegan diet. The patient never followed a vegan diet.
- Date of photographs. The photographs in Figures B and C of the article by Jelinek and Gawler were taken on 7 July 1977 (Box 2), not at the time of first contact with Meares, as implied in the article.
An appraisal of the patient’s symptoms, combined with an accurate clinical history, reveals a more plausible scientific hypothesis for his remission than the effects of diet and meditation. Although diet and meditation may be adjuncts to a patient’s wellbeing, it is unlikely in this case that they were curative, and certainly veganism was not a relevant factor. Immunotherapy with BCG vaccine treatments, the timing of symptoms and the patient’s eventual diagnosis of tuberculosis could be associated with his remission, as postulated by his radiation oncologist in 1978.6 There is extensive scientific literature about remission of cancer, including osteosarcoma, associated with febrile conditions.5,8–15
The patient’s sporadic visits to doctors meant that metastases were not diagnosed histologically and much of the information reported on his case is anecdotal. Clearly, in this and other cases, unbiased investigative scientific research needs to be undertaken before reporting anecdotes and extrapolations as if they were fact. Teasing apart the errors in Jelinek and Gawler’s story, now on the public record and almost medical myth, is an enormous task, but one that must be done, because correctly reporting the patient’s clinical timeline is crucial in any discussion about the causes of his remission and the flow-on effect to cancer patients and their treating doctors.16
1. Corrections and errors in the2008 article by Jelinek and Gawler1 Select link for PDF
Acknowledgements: I would like to thank Professor Ray Lowenthal for his assistance in structuring the article and feedback, and the staff of Australian Doctor for their assistance in retrieving archived material.
Competing interests: I am a co-founder of the Gawler Foundation and the former wife of the patient. I left the employ of the Gawler Foundation in 1996. My memoirs were published in October 2008 as an aid to correcting years of misinformation and misreporting about my former husband’s remission.
- Jelinek GA, Gawler RH. Thirty-year follow-up at pneumonectomy of a 58-year-old survivor of disseminated osteosarcoma. Med J Aust 2008; 189: 663-665. <eMJA full text> <PubMed>
- Gawler I. Cancer patients find strength in self-help approach. Aust Doct 1993; Sept 3: 25.
- Gawler I, editor. Inspiring people: stories of remarkable recovery and hope from the Gawler Foundation. Yarra Junction, Vic: Gawler Foundation, 1995.
- Gerson MA. Cancer therapy: results of 50 cases. New York: Station Hill Press, 1995.
- McCarthy EF. The toxins of William B Coley and the treatment of bone and soft-tissue sarcomas. Iowa Orthop J 2006; 26: 154-158. <PubMed>
- Allenby G. Ian Gawler: the dragon’s blessing. Sydney: Allen and Unwin, 2008.
- Gawler I. You can conquer cancer. Melbourne: Hill of Content, 1984.
- Kleef R, Jonas WB, Knogler W, Stenzinger W. Fever, cancer incidence and spontaneous remissions. Neuroimmunomodulation 2001; 9: 55-64. <PubMed>
- Theilmann L, Meyer U, Kommerell B, et al. [Alpha tumor necrosis factor in the serum of patients with sarcoidosis, tuberculosis or bronchial cancer] [German]. Pneumologie 1990; 44: 735-738. <PubMed>
- Hortobagyi GN, Richman SP, Dandridge K, et al. Immunotherapy with BCG administered by scarification: standardization of reactions and management of side effects. Cancer 1978; 42: 2293-2303. <PubMed>
- Gkialas I, Kalantzis A, Lykourinas M. The response of urological tumours to immunotherapy. J BUON 2005; 10: 329-336. <PubMed>
- Terlikowski SJ. Tumour necrosis factor and cancer treatment: a historical review and perspectives. Rocz Akad Med Bialymst 2001; 46: 5-18. <PubMed>
- Wiemann B, Starnes CO. Coley’s toxins, tumor necrosis factor and cancer research: a historical perspective. Pharmacol Ther 1994; 64: 529-564. <PubMed>
- Nauts HC. Osteogenic sarcoma: end results following immunotherapy (bacterial vaccines) 165 cases, or concurrent infections, inflammation or fever, 41 cases. New York: Cancer Research Institute, 1975. (CRI Monograph No. 15.)
- Hirshberg C, O’Regan B. Spontaneous remission: an annotated bibliography San Francisco, Calif: Institute of Noetic Sciences, 1993.
- Lowenthal RM. Can cancer be cured by meditation and “natural therapy”? A critical review of the book You can conquer cancer by Ian Gawler. Med J Aust 1989; 151: 710-715. <PubMed>
Read the 2008 gawler and Jelinek article for comparison – select link below.