Doctor Of Hope

Nothing about Luigi Di Bella stands out. He's not tall. His dark suit, by Italian standards, is rather plain. Even the restaurant where he's having coffee is unremarkable. But it is easy to see why a cancer patient would be drawn to this kindly 90-year-old doctor with grandfatherly eyes and a face like a koala's. Di Bella is a terrific listener. His consultations with patients can last hours. He wants to hear about symptoms, complaints and life stories. Then, taking all this into account, he fixes up a special cocktail--of prescription and nonprescription drugs, vitamins, hormones and homeopathic medicines--tailored for the patient at hand.

By most accounts, patients are satisfied. In 35 years, Di Bella has used his "multiple therapy" treatment on roughly 10,000 cancer sufferers. His Web site displays their testimonials. Claudio of Turin thanks the doctor for providing hope in his fight against throat cancer; Marzia of Milan writes of the courage and renewed hope the doctor has given her mother in her struggle against lymphoma. In response to popular sentiment, the Italian Parliament earlier this year voted to include Di Bella's treatment in the national health service.

There's only one problem with this success story: according to his colleagues, Di Bella's practices have about as much to do with medical science as the wizardry of Harry Potter. "The hidden dangers of quackery in cancer treatment are well exemplified" in Di Bella's work, says Gianfilippo Bertelli, an oncologist at the National Cancer Research Center in Genoa. Silvio Garattini, a pharmacologist in charge of the Mario Negri Institute in Milan, says Di Bella's cure is a "totally irrational association of drugs supported by absolutely no scientific evidence or data whatsoever." Di Bella has never published a word about his treatments in a peer-reviewed journal, and clinical trials have debunked them. So why do patients flock to him? Could it have something to do, as one detractor says, with the "universality of popular delusion"?

When Di Bella came to the public's attention in 1998, few medical doctors outside Italy had heard of him. It started with a series of television appearances, complete with evangelist-style testimonials from survivors, touting the success of his treatment. He claimed to have cured not only several of the most severe types of cancer, such as Hodgkins disease and lung cancer, but Alzheimer's and multiple sclerosis as well. Patients stormed the Italian Health Ministry and issued death threats against the then Health Minister Rosy Bindi unless the health service began paying for the treatments. She gave in, she said, to "preserve public order." She also started the first Italian state-run clinical trials of the treatment. The results, which arrived a few months later, were not kind to the doctor: of 386 cancer patients who underwent Di Bella's treatment, none went into complete remission; three showed partial remission. A second trial the next year showed that the disease had stabilized in 12 percent of patients and progressed in 52 percent; 25 percent died. The journal Cancer also looked at records of patients under Di Bella's care and concluded that their five-year survival rate was "significantly lower than for patients receiving conventional methods." The British Medical Journal found "insufficient efficacy to warrant further clinical trials."

Di Bella accused the journals of bias. "The narrow view is influenced by the international drug industry, which supports medical peer-review journals through advertising, free gifts, free samples and research grants," he said to Italian magazine Panorama in 1998. The British Medical Journal later admitted that its study may have allowed bias to creep in. The clinical trials proved nothing, says Di Bella, because most of the patients who opt for his treatment are too far gone for chemotherapy, surgery and radiation.

That's exactly what other practitioners of Di Bella's methods have found. Oncologist Aaron Malkin opened the first cancer clinic in Canada to offer Di Bella's treatment in Toronto in late 1999. At first, interest among cancer patients was "overwhelming," he says. But he found that patients with the best chances of recovery generally opt for conventional methods, while the most desperate ones go for Di Bella's treatment. Apparently they want just one last chance for a miracle. Di Bella's "cure" may not have much to do with science or even health care, but perhaps there's some value to it nevertheless.