Abraham Cherrix update

Finally, a cheery update on the health status of Abraham Cherrix, the Chincoteague teen battling cancer.

At the Pangea conference which opens tomorrow in San Francisco, one of our hotly anticipated session is on the ethical use of CAM in seriously ill children. This issue has been particularly debated in pediatric oncology circles, as a few cases have made national news when families and children choose alternative routes of cancer treatment, sometimes in place of conventional care; though more commonly, families use CAM as complementary therapy along with conventional care. An example is acupuncture for nausea associated with chemotherapy, a subject worthy of a Cochrane Database Systematic Review.

Abraham Cherrix, a Virginia teen, first made headlines last year. I detailed Abraham’s difficulties with the medical and legal systems in the summer of 2006, when he was threatened with removal from his parents’ custody due to disagreement with medically advised aggressive cancer treatment for his recurrent Hodgkin’s Disease. I happened to be working out at the Imus Ranch the week the story broke, and gave my two cents during an interview on the show one morning.

After much legal battling, Cherrix was finally allowed to pursue his own integrative path, combining radiation therapy with CAM therapies. The good news? The Virginian-Pilot reports, “Cherrix’s cancer in ‘total remission’ after radiation treatments.” Another hopefully long lasting effect of the young man’s fight to pursue his own path is “Abraham’s Law,” signed by Virginia Governor Timothy M. Kaine this past March. The law allows teenagers 14 or older and their parents to refuse medical treatments for cancer and other diseases under certain conditions. Adolescents and their families now have more latitude to integrate complementary and alternative therapies into their medical treatment.

For much more on ethics and CAM, see Michael Cohen’s excellent blog here.

Here are selected references of relevance:

ETHICS

Cohen MH, Eisenberg DM: Potential physician malpractice liability associated with complementary and integrative medical therapies. Ann Intern Med 136: 596-603, 2002.

Cohen MH, Kemper KJ: Complementary therapies in pediatrics: a legal perspective. Pediatrics 115: 774-780, 2005.

Cohen MH, et al: Emerging credentialing practices, malpractice liability policies, and guidelines governing complementary and alternative medical practices and dietary supplement recommendations: a descriptive study of 19 integrative health care centers in the United States. Arch Intern Med 165: 289-295, 2005.

Cohen MH, et al: Pediatric use of complementary therapies: ethical and policy choices. Pediatrics 116: e568-e575, 2005.

Cohen MH: Legal and ethical issues relating to use of complementary therapies in pediatric hematology/oncology. J Pediatr Hematol Oncol 28: 190-193, 2006.

Kemper KJ, Cohen M: Ethics meet complementary and alternative medicine: new light on old principles. Contemp Pediatr 21: 61-72, 2004.

ONCOLOGY



Hawks R: Complementary and Alternative Medicine Research Initiatives in the Children’s Oncology Group and the Role of the Pediatric Oncology Nurse. J Pediatr Oncol Nurs 23: 261-264, 2006.

Johnston DL, et al: Complementary and alternative medicine in pediatric oncology: availability and institutional policies in Canada – a report from the Children’s Oncology Group. Pediatr Blood Cancer 2006 Jan 12; Epub ahead of print.

Kelly KM, et al: Use of unconventional therapies by children with cancer at an urban medical center. J Pediatr Hematol Oncol 22: 412-416, 2000.

Kelly KM: Complementary and alternative medicines for use in supportive care in pediatric cancer. Support Care Cancer 2006 Oct 12; [Epub ahead of print].

Kemper KJ, Wornham WL: Consultations for holistic pediatric services for inpatients and outpatient oncology patients at a children’s hospital. Arch Pediatr Adolesc Med 155: 449-454, 2001.

Ladas EJ, et al: Evidence for symptom management in the child with cancer. J Pediatr Hematol Oncol 28: 601-615, 2006.

Martel D, et al: Use of alternative and complementary therapies in children with cancer. Pediatr Blood Cancer 44: 660-668, 2005.

McLean TW, Kemper KJ: Complementary and alternative medicine therapies in pediatric oncology patients. J Soc Integr Oncol 4: 40-45, 2005.

McLean TW, Kemper KJ: Lifestyle, biomechanical, and bioenergetic complementary therapies in pediatric oncology. J Soc Integr Oncol 4: 187-193, 2006.

Melnick SJ: Developmental therapeutics: review of biologically based CAM therapies for potential application in children with cancer: part I. J Pediatr Hematol Oncol 28: 221-230, 2006.

Melnick SJ: Developmental therapeutics: review of biologically based complementary and alternative medicine (CAM) therapies for potential application in children with cancer-part II. J Pediatr Hematol Oncol 28: 271-285, 2006.

Myers C, et al: Complementary therapies and childhood cancer. Cancer Control 12: 172-180, 2005.

Neuhouser ML, et al: Use of alternative medicine by children with cancer in Washington state. Prev Med 33: 347-354, 2001.

Post-White J, et al: Future Directions of CAM Research in Pediatric Oncology. J Pediatr Oncol Nurs 23: 265-268, 2006.

Post-White J, Hawks RG: Complementary and alternative medicine in pediatric oncology. Semin Oncol Nurs 21: 107-114, 2005.

Quimby EL: The use of herbal therapies in pediatric oncology patients: treating symptoms of cancer and side effects of standard therapies. J Pediatr Oncol Nurs 24: 35-40, 2007.

Sencer SF, Kelly KM: Bringing evidence to complementary and alternative medicine for children with cancer. J Pediatr Hematol Oncol 28: 186-189, 2006.