I'm depressed and angry as I write this.

The reason for this is simple. I hate it when cancer quacks claim the lives of patients with cancer, particularly patients who were eminently treatable for cure. It's happened again, and it makes me sad. Florida cancer quack Brian Clement has claimed the life of Makayla Sault, an 11 year old Ojibwe girl with leukemia:

The entire community of New Credit is in mourning today, following the news of the passing of 11 year old Makayla Sault. The child suffered a stroke on Sunday morning and was unable to recover. Friends and family from across the province travelled to New Credit First Nation today to offer condolences, share tears and pay their respects.

I first discussed the case of Makayla Sault in the context of the story of a First Nations girl with cancer, whose fate was almost certainly sealed when a Canadian judge ruled that she could pursue "traditional" treatment in lieu of curative chemotherapy for her lymphoblastic leukemia, even though what she and her family were choosing had nothing to do with traditional aboriginal healing. Rather, instead they took the First Nations girl to Brian Clement, a quack who isn't even a physician but somehow has been treating patients with cancer at Hippocrates Health Institute in West Palm Beach for many years now with his "Life Transformation Program" that includes:

Superior nutrition through a diet of organically-grown, enzyme-rich, raw, life-giving foods

Detoxification

Wheatgrass therapies, green juice, juice fasting

Colonics, enemas, implants

Exercise, including cardio, strength training and stretching

Far infrared saunas, steam room

Ozone pools, including: dead sea salt, swimming, jacuzzi and cold plunge

Weekly massages

Bio-energy treatments

Med-spa & therapy services

I described it all in an old post in which I had first encountered Clement. In particular, Clement seems to have a thing for treating people with wheatgrass enemas. Wheatgrass, according to Clement, can increase red blood cell count, decrease blood pressure, cleanse the blood, organs and GI tract of “debris,” stimulate the thyroid gland, “restore alkalinity” to the blood, “detoxify” the blood, fight tumors and neutralize toxins, and many of the usual other things quacks like Clement claim. He even offers the infamous "detox footbath," plus intravenous vitamin therapy, cranial electrotherapy stimulation, combination infrared waves plus oxygen, acupuncture, colon hydrotherapy (apparently with or without wheatgrass) and lymphatic drainage. There's even a bit of quackery hilariously called colorpuncture, in which various colors are applied to acupuncture points.

You get the idea. Brian Clement's clinic has nothing to do with Ongwehowe Onongwatri:yo (indigenous medicines) and everything to do with good, old-fashioned European-American quackery focused mainly on wheatgrass, raw vegan diet, and "detoxification."

Unfortunately, another child who very well might have been saved and lived to a ripe old age is dead, her whole life ahead of her having been thrown away pointlessly, because her family relied on quackery instead of effective medicine. Once more, a cancer quack has claimed a very salvageable life. The saddest thing about this is that this outcome didn't have to be. All reports indicate that Makayla's tumor was a treatable variety. In fact, it was the same kind of cancer the First Nations girl whose case I discussed has, lymphoblastic leukemia, although it wasn't as favorable a variety. Pediatric oncologists estimated that Makayla had a 70% chance of surviving five years, because the cancer had the Philadelphia chromosome. So, yes, it's quite possible that Makayla could have been treated with the very best drugs modern medicine has to throw at lymphoblastic leukemia and died anyway, nearly a one in three chance. However, by abandoning chemotherapy and choosing Clement's quackery instead of Makayla's best shot at a cure, Makayla and her family reduced her chances of survival from 70% to zero.

To be honest, after the descriptions of how her condition was deteriorating in November when I originally wrote my posts about the First Nations girl, I'm a little surprised that she lasted two whole months more. From the news reports, she sounded as though she was in bad shape in November. But last she did.

Now Makayla's parents have suffered the worst loss a parent can suffer. They are, no doubt, suffering intensely, as is Makayla's entire family and tribe, over the loss of their beloved. I do not blame either Makayla or them; I blame Brian Clement for duping them. Unfortunately, as is often the situation in these cases, the Sault family is not accepting that the cancer killed Makayla. They're blaming—you guessed it!—the chemotherapy. In a statement, they said:

Makayla was on her way to wellness, bravely fighting toward holistic well-being after the harsh side effects that 12 weeks of chemotherapy inflicted on her body. Chemotherapy did irreversible damage to her heart and major organs. This was the cause of the stroke. We continue to support Makayla’s choice to leave chemotherapy. At this time we request privacy from the media while we mourn this tragic loss.”

Yes, as happens so often in these cases, it's not the quack's fault that the child died. It's the fault of those evil "Western" doctors and their poisonous chemotherapy. Always. Unfortunately, a stroke is a known complication of leukemias due to either cancer-related coagulopathy or complications of treatment. It's one way that patients with end stage leukemia die. Given that Makayla hadn't been treated in months, her stroke was almost certainly due to her cancer. Such strokes can be a hemorrhagic (for example, if the platelet count falls very low), or it can be a thrombotic stroke (clot) if the white blood cell count goes too high. Either way, it's not particularly surprising that Makayla, with untreated leukemia, suffered a fatal stroke. It was almost certainly end stage cancer the killed her, not the side effects of the chemotherapy.

In a way, I can't blame the Saults for believing that it was the chemotherapy that killed their daughter. I really can't. It's completely understandable. If they stopped believing that, then they would have no choice but to accept that it was the choice to abandon chemotherapy that doomed their daughter. That's just not something that any parent is likely to be able to admit.

Unfortunately, I see this happening to another child in the not-too-distant future. Remember, there is still another aboriginal girl with lymphoblastic leukemia who has abandoned chemotherapy, with the blessing of her tribal chiefs and family, in favor of the quackery peddled by a Yankee in Florida. We don't know her name due to privacy concerns enforced during her court case but we do have an update about her condition to juxtapose with the death of Makayla Sault. Not surprisingly, due to the usual misunderstanding that families who abandon chemotherapy for quackery for hematologic malignancies nearly always have, her family believes she is doing well because her latest tests have failed to find residual cancer:

The 11-year-old at the centre of a controversial ruling on aboriginal medicine tested negative for signs of cancer, her family says, months after she was pulled out of chemotherapy early in favour of natural therapies. According to a published statement, the family credits the alternative treatment for the remission. But oncologists say it may be the result of the two weeks of chemotherapy the girl underwent at McMaster Children’s Hospital in August before her mother pulled her out.

There's no "may" about it. It's almost certainly the result of the chemotherapy that the girl underwent in August. I've explained this concept several times of late. For hematologic malignancies like this, there are several phases of chemotherapy, starting with the induction phase. The induction phase is designed to put the patient rapidly into remission. However, as pediatric oncologists (not to mention adult oncologists who treat hematologic malignancies) learned the hard way decades ago, it requires sustained courses of chemotherapy to prevent leukemias from rapidly recurring. Basically, it's often easy to get a patient into remission, but keeping the patient in remission is harder.

One good thing about this article is that the reporter interviewed some actual oncologists who explained this concept rather well:

“From my perspective, there’s lots that traditional healing can offer in terms of symptom management and support, but based on my scientific training I think it’s exceptionally unlikely that traditional medicine has cured her of her disease,” said pediatric hematologist and oncologist Dr. David Dix, a clinical professor at the University of British Columbia. “It is quite possible that she went into remission after the first two weeks of chemotherapy,” he said. Dix said the likelihood of the cancer returning is “100 per cent” and that any return of the cancer will be more difficult to treat.

And, later in the article:

The typical course of treatment for lymphoblastic leukemia involves four weeks of intensive chemotherapy which puts “99.9 per cent” of people into remission, Dix said. That is normally followed by about six months of heavy chemotherapy, then about two years of maintenance chemotherapy. “Achieving remission, even with a short duration of chemotherapy, is expected,” said Dr. Kirk Schultz, professor of pediatrics at the University of British Columbia. “The whole focus of chemotherapy in children with acute lymphoblastic leukemia is to get a curative outcome, that they cure the disease and it never comes back.”

And the conclusion of the article:

“Any pediatric oncologist would tell you that the likelihood of her disease recurring or relapsing is 100 per cent, that she’s at very high risk of recurrence for her disease,” said Dix. “When she does relapse it becomes more difficult then to get her back into remission. It’s very much better to get her back into chemotherapy as soon as possible.”

So what we have in this second girl is the same story as Makayla's, probably delayed by several months or maybe a bit longer, given that this girl's cancer is not quite as nasty as Makayla's was. Her cancer will eventually recur, probably within the next year or two at most, and at that point it will be much more difficult to eradicate than it would have been if the girl had only undergone standard-of-care chemotherapy and completed the full course. She didn't.

The hard part will come when this girl's leukemia, as is almost inevitable now, recurs. What will the parents do? Will they admit that the combination of "traditional" medicine and Brian Clement's quackery didn't work and finally let their daughter be treated with state-of-the-art chemotherapy? At this point, that is probably the best outcome that can be expected, because they're clearly never going to bring her back to have her leukemia treated correctly as long as she is tumor-free, even though that would be the course of action that would maximize their daughter's odds of survival. The problem, of course, is that this honeymoon period probably won't last very long. The clock is ticking.

Unfortunately, I fear that when this girl's cancer does recur, the parents will not change course. After all, this is what the girl's mother has said:

In an interview with CBC News, her mother said, “This was not a frivolous decision I made. Before I took her off chemo, I made sure that I had a comprehensive health-care plan that I was very confident that was going to achieve ridding cancer of her body before I left the hospital. This is not something I think may work, this is something I know will work.”

Unfortunately for this woman's daughter, it is doubtful that she will be able to admit that this "something" didn't work, even after the leukemia recurs. Then we'll have a second Makayla Sault, another dead girl.

It's so sad, and so preventable.