Was This a Miracle?
Dr. Richard Westcott is a general practitioner who, while describing himself as an atheist, wrote to the British Medical Journal wanting to know how he should respond to what happened to one of his patients. Jim, a nonreligious man, was suffering from asbestosis, which he acquired as a result of his work as a submarine engineer. Then he was diagnosed with a mesothelioma of the chest wall (Westcott, 2002).
This is a well-known complication of asbestosis, and it is a malignant tumor that is regarded as invariably fatal. Radiotherapy had little effect and Jim was becoming weaker. His wife decided that they should go for a Mediterranean vacation, and they picked the Greek island of Kefallinia. While there they visited a monastery where an old nun singled Jim out and asked him what his illness was. She took him to a priest who performed some kind of prayer or ritual involving some holy relics. Immediately after this Jim felt stronger, and later his recovery continued. The tumor was now no longer apparent and Jim seemed to be in remission, though Dr. Westcott was still concerned that he might relapse later. (Dr. Westcott has told me that Jim did in fact relapse.)
Skeptics who are confronted with cases of this kind generally take refuge in two kinds of objection: either the original diagnosis was wrong or the cure was due to the conventional treatment that the patient had received previously. Neither of these seems likely to apply in the present case, nor in a number of others. So does this mean that we must accept that divine intervention, or at least paranormal healing, is a reality? Do miracles really occur? Cases like that reported by Dr. Westcott certainly provide food for thought, but before accepting them as proof positive of the miraculous, I think we need to look a little more closely at what they actually tell us.
Why Do Apparent Miracles So Often Relate to Cancer?
I find it interesting that so many claims for miraculous cures concern recovery from cancer. These are highly impressive and dramatic, and to many people they seem to provide incontrovertible evidence for a miracle. But how often does cancer remit spontaneously outside a religious context?
Do Spontaneous Cancer Cures Occur?
I carried out a search via Medline for reports of spontaneous remissions of cancer (that is, remissions occurring without treatment, or with inadequate treatment). This produced some twenty-odd papers on the subject; there are doubtless many more to be found. The cancers reported to have remitted spontaneously include:
- adult T-cell leukemia/lymphoma (Takezako et al., 2000)
- adult T-cell leukemia (Murakawa et al., 1990)
- esophageal leiomyosarcoma (Takemura et al., 1999)
- lung cancer following myxoedematous coma (Hercbergs, 1999)
- hepatocellular carcinoma (2 cases; Magalotti et al., 1998)
- non-small-cell lung cancer (Kappauf et al., 1997)
- lung metastases from primary uterine cancer (Mastall, 1997)
- liver cancer (Van Halteren et al., 1997)
- pleural and intrapulmonary metastases from renal carcinoma (Lokich, 1997)
- squamous cell lung cancer (Schmidt, 1995)
- bladder cancer (Hellstrom et al., 1992)
- intrahepatic, peritoneal and splenic metastases after hepatectomy for hepatocellular carcinoma (Terasaki et al., 2000)
- disappearance of lung metastases from hepatocellular carcinoma (Toyoda et al., 1999
- large-cell and polymorphic lung cancer with extensive metastatic disease (Kappauf et al., 1997)
- metastatic malignant melanoma (Hurwitz, 1991); several similar cases cited in the literature
As this undoubtedly incomplete list indicates, spontaneous remission of cancer, though very rare, does occur and is well authenticated outside of a religious context. This will probably come as a surprise to many people, including some doctors. How do such events come about?
Possible Mechanisms of Cure in Cancer
A number of papers discuss possible mechanisms by which spontaneous remission of cancer might occur. The most popular suggestion is some form of immunological reaction, though this is still unproven (Lokich, 1997; Heim & Kobele, 1995). There seems to be a connection between fever and remission of cancer (Murakawa et al., 1990); fever in childhood or adulthood may protect against the later onset of cancer, and spontaneous remissions are often preceded by feverish infections (Kleef et al., 2001). The case of remission following myxoedema coma (Hercbergs, 1999) suggests that hypothyroidism may trigger apoptosis (cell death) in tumors. Yet another idea is that DNA methylation, which is involved in cell differentiation, may play a part (Sugimura & Ushijama, 2000). And there is a long-standing impression that psychological states influence the functioning of the immune system.
A cell biologist, Uwe Hobohm, believes that it is time to revive an old idea: the treatment of cancer by means of fever. This was done, apparently successfully, in the nineteenth century. Hobohm discusses the immunological basis for the treatment in New Scientist (‘Hot, Toxic and Healing,’ January 4, 2014). Hobohm and his colleagues are testing the idea in mice.
In summary, then, while the mechanisms of spontaneous remission are by no means fully understood, there are plausible suggestions to explain it.
Limits to the Miraculous
What emerges from the cases I have cited is that if we divide diseases into those that may, no matter how rarely, recover spontaneously and those that don’t, we must place cancer in the “may recover” category. This means that cancer cures, no matter how gratifying to patients who experience them and to their relatives, are not necessarily miraculous. They lie within the boundaries of the natural world.
What, then, would count as a genuine miracle, an event that could not be accommodated within the realm of the natural? It is of course difficult to set limits on what can occur naturally, but I think an example of something which, if it happened, would have to be taken as miraculous would be the regrowth of an amputated finger or limb.
If this seems a lot to ask, how about something seemingly simpler? An optic nerve damaged by glaucoma never recovers its function in the ordinary course of events; sight lost through glaucoma is lost for good. If sight were restored in a reliably diagnosed glaucomatous eye, that would count as a miracle in my opinion (I’d certainly like it to happen to me). But to my knowledge no such case has been reported. These are just two examples out of many; what we need for a “genuine” miracle is recovery from some accident or illness in which no spontaneous cure has ever been shown to occur. But cancer doesn’t fit the bill.
I therefore think that, although there are well-attested instances of spontaneous recovery from cancer within a religious or paranormal context, this is not convincing evidence for divine intervention. The fact that a patient recovers after having been prayed for doesn’t prove that the prayer was responsible for the recovery.
Alternative Explanations for Apparently Miraculous Cures of Cancer
It could be coincidence. We don’t know how many patients suffering from cancer are prayed for, but the proportion is probably considerable. We don’t normally hear about those for whom the prayers are not answered. If very many patients are prayed for, it’s possible that among these there will by chance be some who recover spontaneously, but who would have done so even if they had not been prayed for.
- The Role of the Immune System
If, as seems likely, the immune system is involved in spontaneous remissions of cancer, the known influence of the nervous system on the immune system could explain why a patient’s beliefs and emotional state might on occasion bring about a remission. The fact that a patient had no conscious expectation of a cure (as in the case reported by Dr. Westcott) doesn’t negate a possible influence of this kind.
- God Uses Normal Means to Produce His Miracles
A believer in miracles could argue that even apparently spontaneous remissions are really miraculous. Perhaps God works his miracles through “normal” physiological pathways, rather than by suspending the ordinary laws of physiology; and perhaps he refrains from curing glaucoma and regenerating amputated limbs in order to keep us guessing, or because he doesn’t want to force our belief. This is logically possible, but unverifiable, and so can be neglected in a scientific context.
Ada, G. L. Host factors important in immune surveillance against tumours. IARC Scientific Publications. (39): 223-239, 1982.
Booth, G. A “spontaneous” recovery from cancer. Journal d’Urologie et de Nephrologie. 78(7): 723-726, 1972 July-August.
Heim, M. E., & Kobele C. Spontaneous remission in cancer. Onkologie. Vol 18(5) (pp. 388-392), 1995.
Heim, M., & Schwarz, R. Spontaneous remission of cancer: Epidemiological and psychosozial aspects. Zeitschrift Fuer Psychosomatische Medizin und Psychotherapie. Vol 46(1) (pp. 57-70), 2000.
Hellstrom, P. A., Malinen, L., Malinen, H. Spontaneous remission of bladder neoplasm. European Journal of Surgical Oncology. Vol 18(5) (pp. 521-523), 1992.
Herbert, V. Unproven (questionable) dietary and nutritional methods in cancer prevention and treatment. Cancer. Vol 58(8 SUPPL.) (pp. 1930-1941), 1986.
Hercbergs, A. Spontaneous remission of cancer—A thyroid hormone dependent phenomenon? Anticancer Research. Vol 19(6 A) (pp. 4839-4844), 1999.
Hercbergs, A., & Leith, J .T. Spontaneous remission of metastatic lung cancer following myxedema coma. Journal of the National Cancer Institute. Vol 85(16) (pp. 1342-1343), 1993.
Hurwitz, P. J. Spontaneous regression of metastatic melanoma. Annals of Plastic Surgery. Vol 26(4) (pp. 403-406), 1991.
Kappauf, H .W. Unexpected benign course and spontaneous recovery in malignant disease. Onkologie. Vol 14(SUPPL. 1) (pp. 32-35), 1991.
Kappauf, H., et al. Complete spontaneous remission in a patient with metastatic non-small-cell lung cancer. Case report, review of literature, and discussion of possible biological pathways involved. Annals of Oncology. Vol 8(10) (pp. 1031-1039), 1997.
Kleef, R., et al. Fever, cancer incidence and spontaneous remission. Neuroimmunomodulation. Vol 9(2) (pp. 55-64), 2001.
Lokich, J. Spontaneous regression of metastatic renal cancer: Case report and literature review. American Journal of Clinical Oncology-Cancer Clinical Trials. Vol 20(4) (pp. 416-418), 1997.
Magalotti, D., Gueli, C., & Zoli, M. Transient spontaneous regression of hepatocellular carcinoma. Hepato-Gastroenterology. Vol 45(24) (pp. 2369-2371), 1998.
Mastall, H. Spontaneous remission of lung metastases of a primary uterus carcinoma during immune therapy. Zeitschrift fur Onkologie. Vol 29(3) (pp. 87-88), 1997.
Merkin, L. The aetiology of cancer: clues from spontaneous recovery. Medical Hypotheses. 4(2):136-40, 1978 Mar-Apr.
Murakawa, M., et al. Spontaneous remission from acute exacerbation of chronic adult T-cell leukemia. Blut. Vol 61(6) (pp. 346-349), 1990.
Niakan, B. A hypothesis on the biochemistry of spontaneous remissions of cancer: Coupling of oxidative phosphorylation and the remission of cancer. Cancer Biotherapy & Radiopharmaceuticals. Vol 14(4) (pp. 297-298), 1999.
Schartz, R., & Heim, M. Psychosocial considerations about spontaneous remission of cancer. Onkologie. Vol 23(5) (pp. 432-435), 2000.
Schmidt, W. Spontaneous remission of a cancer of the right lung, following left side pneumonectomy because of squamous cell lung cancer, four years ago. Atemwegs- und Lungenkrankheiten. Vol 21(10) (pp. 536-538), 1995.
Sugimura, T., & Ushijima T. Genetic and epigenetic alterations in carcinogenesis. Mutation Research—Reviews in Mutation Research. Vol 462(2-3) (pp. 235-246), 2000.
Takemura, M. et al. Case of spontaneous regression of metastatic lesions of leiomyosarcoma of the esophagus. Diseases of the Esophagus. Vol 12(4) (pp. 317-320), 1999.
Takezako, Y., et al. Spontaneous remission in acute type adult T-cell leukemia/lymphoma. Leukemia & Lymphoma. Vol 39(1-2) (pp. 217-222), 2000.
Toyoda, H., et al. Hepatocellular carcinoma with spontaneous regression of multiple lung metastases. Pathology International. Vol 49(10) (pp. 893-897), 1999.
Van Halteren, H. K., et al. Spontaneous regression of hepatocellular carcinoma. Journal of Hepatology. Vol 27(1) (pp. 211-215), 1997.
Westcott, R. Can miracles happen? British Medical Journal 2002;325:553.