Surviving Against All Odds

When Peter Hettel's doctors told him what it would take to save his life, he knew he wanted no part of it. Laser surgery hadn't tamed the aggressive tumor on his sinus, so the physicians proposed opening his head to remove the whole gland and the nearby pituitary as well. After surgery would come radiation therapy and, possibly, blindness. Rather than submit to that ordeal, Hettel, a fortyish software designer with a wide bohemian streak, followed what he calls ""my tendrils of intuition.'' He gave up a cigarettes-and-stale-coffee diet in favor of carrot juice and vitamin supplements. He took up meditation and yoga. And, at the urging of an alternative therapist, he crawled around and wiggled his eyes to create harmony between the hemispheres of his brain. Just a few months later, Hettel was practicing a wide, yogic yawn when he got a terrific nosebleed and found himself spitting out chunks of what felt like pink rubber eraser. When the bleeding stopped, there was just a hole where the tumor had been pushing through the roof of his mouth. As a medical exam later confirmed, he was cancer-free.

Somehow, a handful of mortally ill cancer patients perform such feats every year. They refuse treatment and get better anyway. Or like George Washington University anatomy professor Marilyn Koering -- the sole survivor among 20 melanoma patients in a gamma interferon study -- they respond to treatments that typically fail. The medical world may dismiss spontaneous remission as a fluke. But in their new book, ""Remarkable Recovery'' (363 pages. Riverhead Books. $23.95), alternative-healing enthusiasts Caryle Hirshberg and Marc Ian Barasch portray it as a natural phenomenon whose causes we need desperately to understand. Working from the medical literature, the authors chronicle dozens of dazzling comebacks, probing them for larger lessons. The book doesn't solve any mysteries, but the stories are thrilling nonetheless, for they remind us that medicine's ultimate weapons lie hidden in our own bodies.

Chief among those weapons is the immune system. Physicians have long noted that as patients throw off their malignancies, they often experience high fevers and terrible inflammation, the hallmarks of an aggressive immune response. Medical researchers are now devising treatments to induce immunity to tumors, but Hirshberg and Barasch are concerned with how people rally their defenses on their own. Does diet make a difference? Is personality relevant? And what about faith?

Where diet is concerned, the evidence is murky. Hettel may have recovered on health food, but others have fared as well on junk food. Twelve years ago, doctors at the Mayo Clinic confirmed that Carol Knudtson of Madison, Wis., had developed a deadly form of lymphoma. She never even thought of giving up burgers and fries for breakfast, yet the tumors in her neck started shrinking almost as soon as they were diagnosed. Without a whit of treatment, they were gone in six weeks.

If carrot juice isn't curative, drinking it in the right spirit may well be. Biochemists have discovered pathways linking the brain to the immune system, and some people seem uniquely equipped to traverse them. Consider Garrett Porter of Hays, Kans., who developed an inoperable brain tumor when he was 9 years old. He stopped receiving medical treatment after radiation failed to arrest it, but he continued to visit a therapist, who helped him visualize his immune cells as spaceships firing on an alien invader. Eventually, the tumor faded from his mental screen, and a real-life CT scan confirmed it had withered. Though he's still wheelchairbound, Porter is now 23, attending college and engaged to be married.

Unfortunately, the Porters of the world remain a tiny minority. For every tumor that miraculously recedes, thousands flourish and kill, and no one knows how to change the dismal odds. Accordingly, some physicians are loath to raise people's hopes. As one wrote to Hirshberg and Barasch, ""I have grave concerns that patients will misinterpret my report . . . and decide to delay or forgo appropriate medical care.'' But the ethics of hope and resignation aren't that simple. If faith can mobilize a person's defenses, then squelching it is not a neutral act but an intervention with weighty implications. Juice fasts and imaginary spaceships may not seem like real medicine, but as ""Remarkable Recovery'' makes clear, they have real uses.