The New Sun

From 1984 until 1997, William Fair was the chairman of urology at the Memorial Sloan-Kettering Cancer Center, one of the premier cancer hospitals in the world. He was an eminent surgeon, who specialized in tumors of the prostate, bladder, testis, and kidney.

Dr. Fair was not one to embrace complementary therapies -- also called holistic, alternative, or integrative -- until a tumor was discovered in his colon.

His journey has lead him to starting a complementary health center with his son, called Health, LLC.

Lese Dunton: What was the turning point for you? When did you begin to know inside that you were healing, that things were getting better.

Bill Fair: I hope I'm still healing...

LD: Definitely.

BF: Statistically, I have to recognize that the chances of a cure are not very high, maybe zero, but the question is how long will rapidly with the tumor grow? I guess one of the things that really influenced me dramatically was the week I spent out at Commonweal at Michael Lerner's program there. This idea of expanding life even if it's not possible to extend life, struck a very responsive chord in me. I think that in terms of healing or being healed, my current approach is to expand life as much as possible for as long as I have left.

I remember I was at a meeting at CapCure, which is Michael Milken's prostate cancer organization -- I was on the scientific advisory board -- and Andy Grove, who was at that time the president of Intel, was introduced as a cancer survivor. He said, well, the first time you hear "cancer survivor" you have to put a qualifier after that, quotations, and it's "so far." We're survivors up to that point, but whether or not you're actually cured or healed is different thing.

There's an important distinction between curing, which means iradicating the disease, and healing, which means healing the mental and emotional aspects of the disease. Some people are cured but they're never healed. Other people are healed even though they may die of their cancer or disease. They've reached an understanding, or balance, or an emotional acceptance, that no one lives forever. They can, even though it's difficult, adjust and make the best of the time they have left.

With Haelth, LLC, I'm taking what I've learned and the benefits I've gotten, to as many people as possible. With cancer, since not only did I have cancer but I'm a cancer doctor, I recognize that there are a lot of other chronic diseases out there that these complementary techniques could benefit.

That's my goal right now, to try to spread the word.

I often say, "The worst religious zealot is a convert," but I think that there's enough scientific evidence to show that these things have value -- modalities like yoga and mediation and so forth. We need to be apologetic about it. I think what's not been done is enough publicity, if you will, or education of the allopathic community, that...look, there are some data out there that shows that things work. Yes, we need more data, but we need that in practically every area of medicine.

LD: I agree.

BF: What the National Institute of Health is doing now with The Center for Complementary Alternative Medicine, is another step in the right direction. I think that physicians, from my experience, are not really opposed to complementary medicine. I'm sure some are.

I think most physicians,
if you can show them some evidence that there's some benefit, are quite open to it.

When I speak around the country, I try to give talks that concentrate just on that aspect. What are the data that show that stress reduction is really helpful in cancer or some of the other things? Physicians are understandably cautious to jump on the bandwagon. If somebody comes and says well, gee, I couldn't breath and I took this yoga and I've started to breathe, and then if you can bolster that with some of the studies on pulmonary function, it makes a much more credible story.

So anyway, in terms of when there's been a turning point, I don't know if there's been a turning point. I try to keep going day by day and expanding whatever time I have left.

LD: In the beginning you tried traditional methods...

BF: Yeah. I went through everything that looked reasonable at the time. I had my right colon removed, then I had two smaller surgeries, one they put a tube into my abdomen, and I had chemotherapy in the abdomen for a few months, and then had the tube removed and then went on standard chemotherapy for a total of a year. I was doing okay then. About a year later, I was found to have a reoccurrence and had another big surgery and, again, was doing all right. Eight months after that, I was found to have another reoccurrence. So, at this point, I really just didn't have any options that were available to me in standard therapy.

I used to like to say, "You can always take another bottle off the shelf. You can always give some more chemotherapy or radiation." But even my surgeon was not anxious to go back in and operate because of the location of this lesion. He didn't want to make me worse. I respected that. I also checked around to see what was available, both here at Memorial and other places throughout the country and throughout the world, there was nothing that looked very good.

It was just that time that Dean Ornish was instrumental. I had been doing some work in nutrition and prostrate cancer in our laboratory and through this met Dean Ornish and have worked with Dean in some of his studies.

So, he's the one who called and said, "You have to go to Commonweal." I was reluctant about doing that, but between Dean and my wife I didn't have much choice, in the final analysis.

I went out there and was so impressed with their concept of dealing with cancer. It's not a treatment center, it's more...mind/body I guess you would put it. It's sort of a discussion of what options are available. They're not recommending any one thing or the other. We did about three hours of yoga a day, and meditation, and group support. You go by yourself, no spouses or anything. It gave me a chance to sort of back off from all this turmoil of, "What am I going to do now? I have a reoccurrence, and this will kill me." and instead really come to grips with what's important in my life.

Given the uncertainly of how much longer I have -- how do I want to spend it? At some point or another everyone, unless there's an accident, has to face this decision. I'd seen so many people spending so much of the last months of their life in a hospital, strapped to an i.v. pole somewhere. I decided I was feeling good -- and I was active. Even though I had this reoccurrence, I was going to try and do whatever I could to, if not cure it, just to slow the growth of it.

LD: Are you taking herbs?

BF: I'm taking herbs. What I did there was, through a lady that was involved with a company that was making some herbal products for prostate cancer, I was put in touch with a traditional Chinese medicine doctor in Shanghai. I never met the man, but through email conveyed my history and things like that to him. He suggested these herbs.

When we took out the tumor a few years ago, which was metastasized, we saved some of it and put it into nude mice in my laboratory. After the tumor grew up we fed the mice the herbs. The tumor shrunk and the mice didn't die. So far, I haven't had to use that vaccine or anything, and the things I've been doing have worked out okay. How long that will last, I don't know, but at least as long as things are going well, that's the path I'm staying on.

LD: That's incredible.

BF: I thought that was a good sign. I'm still's a little different herbal preparation...but I'm still doing that.

LD: What's the name of that herb?

BF: It's marketed now as Spes (pronounced Spez). It's a combination of eight herbs. It's a lot of mushrooms. This same company makes a product that, at that time it was their only product, which they called PC-Spes. Spes means"hope" and PC stands for prostate cancer. It's an interesting product.

LD: What are your goals with Haelth, LLC. ?

BF: In the simplest terms, my goals are to let the people know, clients but also physicians, that there is a role for these modalities in the treatment of a variety of chronic diseases. It doesn't have to be "all or none." These things can be used at the same time you're using allopathic medicine. That's why I like the term "complementary" instead of "alternative."

LD: Yes. Great word.

BF: So that's number one. And for the physician, what I see happening is that the patients are getting more and more interested in this. There are all kinds of articles showing that there's an interest. There are more patients going to alternative medicine practitioners than there are to primary care physicians. People are voting with their feet and their pocketbook. I think their interest in medicine -- I'd like to think it came from the medical profession but it really didn't -- it came because patients are interested and doctors are following. That's okay as long as they're not working at odds to each other.

What we hope to be able to do is to essentially market Haelth to the physicians as being scientifically credible. Even if the physicians have some interest, and maybe even some training in complementary medicine -- which of course most of us don't -- the major problem of getting this into mainstream medicine is the fact that insurance companies and the HMOs are saying, "You have to see more patients in a given period of time."

I have friends that practice at an HMO in California, for instance, and they're given eight minutes to see a follow-up visit -- seven visits an hour.
I don't know how you can do that.

LD: That's interesting.

BF: I don't see how you could possibly do it. What we're hoping to capture is a physician who has an interest in this and doesn't have the expertise and certainly doesn't have the time to do it. We can market Haelth as an extension of the physician's office. They'll be no physicians working in a health facility. So, unlike some of the others where there are MDs or chiropractors or naturopaths or something -- if the physician refers a patient to Haelth, he or she doesn't have to worry about that patient being stolen or never seeing the patient again.

It's important for physicians to have the patient go to a place where they can get an integrative approach to complementary medicine as it relates to their disease. My plan for this is that someone will come in who has, say, diabetes. He or she will be evaluated by a nutritionist, an exercise physiologist, stress reduction, maybe have group support, acupuncture and so on. It surprises me how disconnected the complementary modalities are right now.

Someone will go to an acupuncturist in one part of the city, and a nutritionist in the other -- and they don't even speak to each other.

So, after having the initial analysis for a patient, having a one-on-one analysis by each of these practitioners, we then will sit around -- and when I say we it's because I'm the scientific, head of the clinical advisory board -- the practitioners will sit around and the session will be directed by someone who, for lack of a better name, we're calling "Case Manager," which will be a nurse practitioner or a clinical nurse specialist.That nurse will serve as someone who will be the interface between the client and the physician.

They'll go around the room and say, okay, here's Joe with diabetes. What kind of recommendations will we make for his diet? What kind of recommendations for exercise? Then, we'll put this together in an integrative plan and, if the patient wants to, communicate that back directly to the patient's physician and say, "Joe was at Haelth, has had the evaluation, this is what our recommendation is: He should have a 1,200 calorie a day diet, it should be no more than twenty percent fat..."

I honestly do think that most physicians would feel very comfortable with this because they're not being cut out of the loop. I think also it would give them the cache of being a "holistic physician." Even though it's not done in that physician's office, at least they're working with Haelth.

LD: And they'd bring in more patients then, as their reputation gets around.

BF: Down the road, it could work both ways. The patients will come to us and maybe they don't have a doctor, or they want to change doctors. "My doctor doesn't like holistic stuff, could you recommend somebody?" At some point we would like to have a panel of physicians that we have worked with and would feel comfortable in sending someone to for various diseases. It could be something where we could help physicians also.

LD: What blessings have you received from this experience?

BF: That's a good question. No one's ever asked me that one. I've thought about this, and there really's not been all bad. I think the blessing is...I, like most physicians, had blinders on to complementary medicine. I think it was through my own search and through interaction with people like Michael Lerner and Jim Gordon and a whole host of other people in this field, that I came to realize that there are really a lot of caring, sincere people out there who believe in their modality and furthermore, they can help.

I'd like help to change medicine whereby it's not looked upon as you either do standard medicine or you do alternative -- which is why I don't like the term alternative. These things really ought to be just part of medicine. To treat someone's diabetes just by saying, "Just take this insulin," without having them speak to someone who's really knowledgeable in the area of nutrition, i.e., a dietitian, and someone who can lay out an exercise prescription and so on and so forth.

Just giving the pill or the shot is not even half of what those people need because so many of the diseases in modern society are lifestyle implications. One of the major benefits has been the fact that I've been able to see the need for something like this and hopefully have been in a position to take advantage of it. We've been able to get the funding to get Haelth started. We're all very anxious to get the site up and running.

The other thing is, a real benefit, is to have to opportunity to meet people in these various disciplines, like I said, yoga, meditation and so forth, and realize just how dedicated and motivated these people are. I don't mean to denigrate it, but sometimes when you're in medicine --and I still think, despite the business aspect, most people, at least when they enter medicine, do so out of a sense of idealism -- we sometimes think we have the corner on that market. I was really amazed to see the number of good people in these fields. We've often heard of charlatans. There are some flakes out there, but there are flakes in every field.

LD: Yeah, that's what I always say.

BF: Yeah. So, I think that was good. The other thing was the opportunity I've had so far to help spread this message. The things like the New Yorker article and Dateline. I've had more than 1,000 phone calls since the Dateline interview. I really enjoy talking to people. I no longer operate (in surgery) myself but I'm involved in research programs for pancreatic cancer from the point of view of the complementary medicine approach.

LD: Oh good.

BF: I'm on the advisory board for the cancer part of the National Center for Complementary and Alternative Medicine. I'm getting involved in conferences. Jim Gordon has had me speak at his conference a couple of times. I've just been asked to be associate editor of one of the main journals of complementary medicine. It's opened up a whole new world to me.

The other thing is, I like myself better. I'm not always frenetically running. I used to pride myself on the fact that I only needed five hours of sleep, and then I was usually running for 19 hours. Now I think, again thanks to meditation, life is more meaningful. I'm not frenetically running through it to get through the day. I love surgery and I think I did it very well, but I also love the opportunity to talk to people. Haelth, the company, has just sort of sprung out of all these thoughts. Wouldn't it be neat to have the chance to really do something like this and make it, aside from just being an idea, a reality. That's been a real plus. It's not been all negative.

I think, what I try to say in my lectures to physicians now, is it's great to cure cancer if you can do that, but let's remember that the majority of diseases we deal with we never cure, and what we do is we try to control. There are many patients who are cured who actually are killed from their therapies. People die from operations and chemotherapy.

There have been several recent studies (May, 1999) looking at things like bone marrow transplantation in women with metastic breast cancer and showing that it does not improve survival and yet it's still the cornerstone of medical practice in some areas. These women should have bone marrow transplantation and just hope that it will work, one in a million, or something like that. Maybe instead of putting people through things like that, especially when we have evidence that it really doesn't work, maybe we can say, well, there are other things that we can do. Let's focus on slowing the progression and keeping the patient comfortable.

I think that's one of the major benefits I've received. To recognize that we have to treat cancer as a chronic disease, much as we do the other chronic diseases. It's not always a go for broke situation.

LD: Interesting. I hadn't thought of it that way. You're providing such a great service...

BF: I hope so. I realize that at this stage of my career if I did another thousand operations, hopefully I'd help those people, but I think this way I really feel that I have an opportunity to do things on a larger scale because if you can change someone with, say, some cancer or diabetes or heart disease, say it's the father or the mother of a family, if you can change their lifestyle, you get them eating properly, doing exercise, and maybe using some of these other modalities, like meditation and so forth -- the chances are that you might influence that whole family. So, it's a trickle down effect.

Hopefully, you may even affect a couple of generations, as opposed to just doing an operation where it only affects the one person.

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