Georges M. Halpern, MD, PhD, attended medical school at the University of Paris, France. He subsequently received a PhD from the Faculty of Pharmacy, University of Paris XI-Chatenay Malabry. A Fellow of the American Academy of Allergy and Immunology, Dr. Halpern is board certified in internal medicine and allergy, and is Professor Emeritus of Medicine at the University of California, Davis.

Contents

Acknowledgments

Introduction
1. Times of Hope
2. What is Disease?
3. The Dark Valley
4. A Visit to a Chinese Hospital
5. A Success Story
6. Nature’s Healing Gift
7. New Beginnings
8. Lingzhi and Yunzhi
9. Invaders and Defenders
10. Winter Worm, Summer Grass
11. The Quest for Common Ground

Glossary
References
Index

Introduction

This book is about cancer, a great modern plague, but it is about much more. Its broader themes, touched on throughout, include how science and medicine evolve and how different cultures in medicine interact with and change one another. It is about the great advances we have made in understanding cancer, but it is also about the tragedy of the millions still dying of this dreaded disease every year. It is also a scientific look at the use of medicinal mushrooms, which the Chinese have used for centuries to treat cancer.

In science and medicine, problems sometimes remain unsolved for decades, even centuries, engendering controversies beyond their fields--to ethics, to morality, and to society at large. Yet, when they are finally solved, there may be no “Eureka!” moment: the transition from the past way of thinking to the present way of thinking may be so seamless, and the new way so natural, that we wonder why there was any fuss at all. Thomas Kuhn, who popularized the term paradigm, called these transitions “invisible revolutions.” In his book The Structure of Scientific Revolutions, Kuhn, one of the most influential thinkers of the twentieth century, argues that scientific progress may be seen as a series of crises and responses to crises, which are part of the nature and necessity of science. His central theme is that scientists cling to an old and dysfunc-tional paradigm, modifying it as they go along, until a new paradigm is ready. This is especially true where an advance involves a new worldview.

Historically, one of the most famous “paradigm shifts” was associated with the discovery of Galileo Galilei (1564-1642) that the Earth revolves around the sun and not vice versa, as the church authorities and most philosophers of Galileo’s time insisted. This was not, as Kuhn pointed out, an abrupt change in astronomical science, coming as it were out of a clear blue sky. Rather, it evolved as the older model of the sun revolving around the Earth became increasingly untenable. Many modifications of the old model were tried and each modification appeared workable for a while. Interestingly, Kuhn pointed out that scientists (and in those days, there was no distinction between science and philosophy) persisted in the cumbersome old model with its many, sometimes contradictory, modifications, until a new paradigm was ready. Nowadays, we often think of the Galileo story as an abrupt event, since the Inquisition threatened to torture him until he recanted. Thus, he became a hero of the scientific Enlightenment and a big stick that some scientists (but not all) still use to hit back at the church. But this has nothing to do with the paradigm shift, which is nearly always an invisible revolution, and more to do with a peculiar attitude, which may be called “fundamentalism.”

A Great Modern Plague
Cancer kills more than four million people each year. Many people are newly diagnosed with some form of cancer each year, and nearly everyone knows someone, a close friend or relative, with cancer. The book is written for them, the cancer sufferers and their families, as well as the dedicated professionals who care for them. This book will trace the history of cancer medicine from ancient times to the present, and look at the very considerable progress in Western medicine, but without an attitude of fundamentalism.

From the standpoint of mainstream medicine, there is both good news and bad news regarding cancer. The good news is that some treatments are working--many forms of childhood cancer can be cured with present day treatments. The bad news is that, for the majority of advanced cancers, conventional treatment doesn’t work very well. That is why there is, we believe, an ongoing invisible revolution in the way we think about cancer, both from the scientific and medical standpoint and from that of the lay public, including the millions of cancer sufferers.

A paradigm is more than theory alone but less than the sum of all relevant theories and practice. It involves frameworks, shared rules, and what might be called “normal” science. In cancer medicine, as in astronomy, it is the everyday practice of normal science exposing contradictions between theory and practice that drives forward the invisible revolution. For example, in the 1960s and 1970s, it was found that chemotherapy could cure some cases of childhood leukemia and that more chemotherapy--stronger doses and combinations of drugs--could cure more cases of leukemia, including even some adults with the disease. Doctors then proceeded to treat many cancers with strong chemotherapy, but with meager results. In retrospect, they might have fallen for the “black raven fallacy”: if it is true that all ravens are black, then it logically follows that all non-black objects are not ravens; but it is a fallacy to think that all black objects are ravens.

Complementary and Alternative Medicine for Cancer
There is another aspect to the story. Cancer sufferers are increasingly interested in “integrative medicine,” a newly emerging field in which complementary and alternative methods of healing are combined with mainstream Western medicine. In many ways, this represents a cry from the heart, a tremor of existential anguish for medicine to hear. What is complementary and alternative medicine (CAM)? It has been defined as a group of diverse medical and health-care systems, practices, and products that are not presently considered to be part of conventional medicine. While scientific evidence exists regarding some CAM therapies, there are key questions that are yet to be answered through well-designed scientific studies, such as whether such therapies are safe and if they work for the diseases or medical conditions for which they are used. Cancer patients have one of the highest rates of CAM use--it is estimated that up to 83 percent of cancer patients use some form of CAM at some point.

In the past fifteen years, CAM practices have gained the attention and interest of many academic institutions. The Society for Integrative Oncology has recently been founded as an international organization for oncology professionals to promote the interaction between mainstream cancer medicine and CAM. What is meant by “integrative oncology,” both in theory and in practice? One way to answer that question is to look at the use of Chinese medicine for cancer, which has a 5,000-year tradition and which forms a large component of CAM. The People’s Republic of China, the world’s most populous nation, has a very high rate of utilization of CAM. This book will look, albeit only briefly, at how integrative medicine works in China and discuss whether there are lessons from the Chinese experience in integrative oncology for the West. A detailed discussion of medicinal mushrooms is included, since they are the main ingredients in herbal treatments for cancer.

From Opposite Ends of the Earth
About two years before the end of the Second World War, the authors discovered the joys of mushrooms, but it was much later that we came to understand their medicinal properties. We were children then, growing up on opposite ends of the earth. There were few toys, and like children almost everywhere, we loved to explore our natural surroundings. We knew every nook in the neighborhood, every tree in the nearby woods where we would go after school. And, of course, school was often interrupted by the war, and so those exploratory trips to the woods often took the place of school.

We knew the small animals and birds that we would find in the woods. We could recognize the fragrance of the fields in different seasons, and after summer rains, we would often find mushrooms in the woods. We were two young boys, the one living in a refugee camp in Switzerland and the other on a farm in southern China, which was at that time occupied by the Japanese Imperial Army. Our parents did not discourage us from looking for mushrooms but told us that some were poisonous and some were edible, indeed delicious. Both of us went on to study medicine after the war and became interested in the treatment of cancer. We both retained our fascination with mushrooms, both as a culinary delicacy and as we gradually became aware of their legendary healing properties.

We did not meet until much later. Georges studied in Paris, practiced as a doctor, first in France and then he later emigrated to the United States, where he became a professor in internal medicine, nutrition, and pharmacology. His interests led him to conduct research in the rapidly expanding sciences of molecular medicine. Still later, he studied the active ingredients in herbal medicine particularly traditional Chinese medicine. Something within has always drawn him toward the East, and after more than twenty years of teaching in California, he went to Hong Kong and became a distinguished professor in pharmaceutical sciences.

Bernard went in the opposite direction. Whereas Georges, the young boy from the refugee camp in Switzerland, became interested in China, Bernard, the young Chinese boy, went to the West. He studied in London and Cambridge and became a doctor, first in England and then in Canada. His field was hematology and his interests led him to study bone marrow transplantation and cellular therapy for cancer.

We eventually met and found that we had many things in common, one of which was an interest in medicinal mushrooms. Out of our friendship came this book.

The Journey Ahead
The plan for this book is simple: alternate chapters are written from a Western and from an Eastern standpoint. By a curious twist of fate, Bernard, originally from China, will contribute the Western perspective. This includes a chapter on the history of cancer treatment from ancient times to the modern development of surgery, radiation oncology, and chemotherapy. He also tells the story of bone marrow transplantation, an undoubted triumph of scientific medicine. A chapter called “The Dark Valley” describes how, despite vast resources over many decades, suffering and death still await the majority of people found to have cancer. “New Beginnings” discusses recent developments of molecular targeted therapy and cell therapy, and the story of cancer vaccines and immunotherapy is covered in another chapter.

Georges, with extensive research interest in medicinal mushrooms, is responsible for the Eastern perspective, although there was much cross-fertilization of ideas. Alternative views of disease in different cultures are discussed--for example, the Chinese concept of disease as a lack of balance in the body rather than simply a failure in a mechanical system, the predominant idea in Western medicine. The cultural and philosophical basis for the practice of medicine in China is described briefly. “A Visit to a Chinese Hospital” takes the reader on a tour to the world of integrative medicine in China, where Western medicine and traditional Chinese medicine are truly partners. Another chapter tells the story of how herbs came to be used for healing, including the story of culinary mushrooms that also have significant medicinal properties. This is followed by a discussion of lingzhi and yunzhi, two mushrooms commonly used to treat cancer in China, as well as the fabled story of a healing mushroom that also has an amazing life cycle inside an insect.

But in what sense is the use of mushrooms a breakthrough? After all, mushrooms have been around since before civilization and their use as rare and precious herbs for Chinese emperors has been documented for hundreds of years. The answer lies in the more recent domestication of mushrooms and the manufacture of their products on an industrial scale. Medicinal mushrooms offered to the emperors were rare specimens collected from the wild--now they are available to all of us.

The book closes with a chapter entitled “The Quest for Common Ground,” in which we look at how both East and West can share a common approach focused on utilizing the immune system to fight cancer, and we discuss cultural and other barriers that need to be overcome before a full partnership can be realized.

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