It's a disease that isn't often in the headlines, but bowel cancer is the second biggest cancer killer in the developed world. One in 20 of us will get it. And contrary to popular belief, women are as likely to get the disease as men. In fact, colon ranks second only to breast cancer as the most frequent cause of cancer in women. It's also the most common cancer in men who do not smoke.

Nevertheless, despite the fact that it's so widespread, colorectal cancer, as it's more properly known, has tended to be a medical Cinderella. While the pharmaceutical companies have been falling over themselves to find "cures" for breast cancer, for example, little attention has been paid to the colon. As a result, conventional medicine's cure rates have been self confessedly disappointing, particularly in advanced cases of the disease. So it's hardly surprising that patients have increasingly been voting with their feet (and cheque books) by seeking help from alternative practitioners.

Medical solutions

In the US, where the battle lines between alternative and conventional therapies have tended to be most sharply drawn, cancer specialists have done their best to convince patients of the benefits of chemotherapy.

They point to seemingly impressive "response rates", not bothering to mention that these rarely translate into significant improvements in survival time or quality of life. And yet patients sometimes appear to have been pressured into accepting chemotherapy, even when the oncologist has known that it has little or no benefit.

A peculiarly candid admission of this practice came in 1978 from a leading US specialist in colon cancer, Dr Charles Moertel of the prestigious Mayo Clinic in Baltimore. "Even when administered in most ideal regimens," he wrote, summarising the value of 5-FU, the major chemotherapeutic drug for colon cancer, "5-FU will produce an objective response in only about 15 to 20 per cent of treated patients. These responses are usually only partial and very transient. This minor gain for a small minority of patients is probably more than counterbalanced by the deleterious influence of toxicity for other patients and by the cost and inconvenience experienced by all patients."

However, after acknowledging that there was no medical justification for prescribing chemotherapy, Moertel concluded with a statement that sums up the view of medicine toward conventional cancer therapies, to wit: we know it doesn't work but it's better than alternative medicine: "This does not imply that (chemotherapy) should be abandoned. Patients with advanced gastrointestinal cancer and their families have a compelling need for a basis of hope. If such hope is not offered, they will quickly seek it from the hands of quacks and charlatans" (New Eng J Med, 1978; 299: 1049-52).

Today, however, conventional medicine is beginning to feel it has something more substantial to crow about in its colon cancer treatments. "Cancer of the colon is a highly treatable and often curable disease," boasts a recent US National Cancer Institute report. "Surgery is the primary treatment and results in cure in approximately 50 per cent of patients."

This crude figure is not, of course, quite what it appears, for "cure" in conventional medical parlance means survival for five years. In fact, colon cancers are rarely "cured" because there is a very high recurrence rate, hence the need for repeated surgical interventions. Most patients who contract colon cancer and submit to conventional medical treatment will ultimately die of the disease.