A Sydney oncologist has warned against using alternative therapies to treat cancer amid the growing popularity of wellness bloggers.
When Chris Wark was diagnosed with stage-three colon cancer at 26, he was told his best chance of survival was surgery followed by chemotherapy.
A course of "adjuvant" chemotherapy is a standard response to a cancer diagnosis and one endorsed by mainstream medicine. But Mr Wark wasn’t convinced. He had surgery to remove a tumour from his large intestine but decided to forgo chemotherapy in favour of a "hardcore nutrition plan," which saw him swap meat, dairy and processed foods for salads and vegetable juices.
He claims nutrition helped his body heal the cancer expected to claim his life.
But Sydney oncologist Professor Martin Tattersall says science doesn't back that up.
Seven years later, cancer free and convinced it wasn’t all a fluke, Chris Wark launched a website called Chris beat cancer: A chemo-free survivor's health blog in 2010. On his website he offers information about nutrition, testimonials from other cancer patients and a personal "Health and Cancer Coaching" service. A one-hour coaching call costs $125 and a two-hour call costs $195. He notes on the site that he is not a doctor and has no medical training.
Mr Wark is one of many "wellness bloggers" around the world who share their experiences online, often rejecting traditional medicine in favour of natural therapies, diet, lifestyle and spirituality. The wellness movement has grown dramatically in the past decade, fuelled by social media and a growing number of people using the internet to discuss "natural" health alternatives.
Other high-profile bloggers include Australia's Belle Gibson, whose claim that she beat terminal brain cancer using natural therapies was later discredited, and Jess Ainscough, whose Wellness Warrior blog amassed legions of devotees before her death earlier this year after a seven-year battle with cancer.
Critics say wellness bloggers pose a risk to vulnerable patients who might choose untested natural therapies over evidence-based medicine at the expense of their health. But bloggers like Mr Wark say they are simply offering information to people who are looking for options outside mainstream medicine.
'Traditional treatments aren't working'
Cancer is the second leading cause of death in Australia after heart disease.
In 2010, 42,844 people died of cancer, according to the Australian Institute of Health and Welfare. Of that number, 24,328 were male and 18,516 female.
Treatments that come under the "wellness" bracket include complementary - which work alongside conventional therapies - and alternative, which are used instead of conventional medicine.
Professor Tattersall says he has seen a huge shift in patient expectations since he started out in the 1970s, and he now spends a lot of time discussing with patients treatments they have seen on TV or the internet.
He says he doesn't advocate for alternative therapies because most haven't been scientifically investigated and says while it is possible to heal cancer with non-drug therapies - "surgery is the obvious example" - he says people should be wary of putting their faith in untested treatments.
But Professor Tattersall does see a place for complementary therapies.
“I’ve seen patients in whom the addition of complementary-style medicines might have been helpful to their wellbeing,” he says. "I have no doubt that acupuncture and relaxation therapy can help patients to cope with the side effects of traditional medicine."
Professor Tattersall says he believes people put their faith in natural therapies and incredible stories of survival because it gives them a sense of control over their bodies and their treatment.
Dr Helen Zorbas, CEO of Cancer Australia, has a similar view. She says patients often feel empowered by making decisions around their treatment rather than taking direction from medical staff.
"It's quite a disempowering position to be in so the search for or use of alternative therapies may be a way of gaining control over the treatment of their disease," she says. "There's also the perception out there that natural therapies may be safer. There are lots of different reasons."
She says Cancer Australia encourages patients to speak openly with their doctors about alternative and complementary treatments.
"I think doctors today are really open to the conversation and in fact encourage the conversation and are sensitive to the needs of patients around taking some control of their situation."
But Chris Wark found doctors he talked to were reluctant to advocate for treatments outside their discipline.
"The oncologist I saw first told me I was insane if I didn't do chemotherapy," he says. "I never went back to him."
And he questions why some doctors don’t look beyond chemotherapy.
"The traditional treatments aren’t working for most patients," he says. "[Doctors in the US] are trapped in a system that pays them really well to do what they’re doing, regardless of the results."
For some of the most popular wellness bloggers, stories of survival and the promotion of natural therapies can translate into celebrity status and big money.
Queensland blogger Belle Gibson, once hailed as a champion of the wellness movement, took a supreme fall from grace this year after she admitted lying about having terminal cancer and curing it with natural therapies and diet. The 'Whole Pantry' app creator said in March that she may have been misdiagnosed by doctors after questions were raised about the veracity of her story. That same month, allegations surfaced that she had withheld money made through her organisation that had been pledged to charities. But in April she admitted to making the cancer claims up, telling The Australian Women's Weekly, "None of it is true."
In the US, Chris Wark says his blog gets thousands of hits each week and he is constantly inundated with messages from readers.
The sheer reach of the internet and the fact that bloggers like he and Ms Gibson are able to influence so many people concerns medical experts.
"[On the internet], so many statements are made as statements of fact, which are very hard to discern from opinion," Dr Zorbas says.
"The person who’s reading the information or subject to that information is in a very difficult position to try and understand the validity of it and what confidence they should place in the information."
Professor Tattersall says the other risk is that people adopting complementary treatments without telling their doctor might be unaware that some can interfere with chemotherapy.
“There is evidence that large doses of vitamin C can interfere with the effectiveness of some components of conventional cancer treatments,” he says.
"So many statements are made as statements of fact, which are very hard to discern from opinion."
But Mr Wark says his blog is for information, not medical advice.
"I'm not a doctor. I don’t claim to give medical advice. My site is for information and education," he says. “There are disclaimers all over it.”
Mr Wark is critical of the funding allocated to cancer research and claims that there is no push to research nutrition as a treatment for cancer because there’s no money in it.
But Helen Zorbas says that is not true in Australia where funding for cancer research is largely independent.
A spokesman for the National Health and Medical Research Council (NHMRC) - Australia's biggest funding provider for cancer research - told SBS that in the last 10 years it has awarded 17 grants for research into complementary/alternative cancer treatments totalling over $10 million and 22 grants for cancer/nutrition research totalling over $18 million.
According to NHMRC records, there are five active grants for research into complementary/alternative cancer treatments and five active grants for research into cancer/nutrition currently under way in Australia.
A public divided
The wellness movement made headlines this year after the death of popular blogger Jessica Ainscough, who battled a rare form of cancer called epithelioid sarcoma for seven years and favoured Gerson therapy - which involves eating large volumes of fruit and vegetables and having regular coffee enemas - for treatment.
Ms Ainscough reportedly worked with both conventional and non-conventional medical practitioners over the years. However, her stance when she first launched her blog in 2010 was strongly natural, and she outlined how and why she chose to go with Gerson therapy over conventional medicine to treat her cancer.
After her death, some members of the medical community spoke out against Ms Ainscough's decision to use natural treatments.
Surgical oncologist and blogger David Gorski wrote on his website that Jess had "one shot" and didn't take it.
"What saddens me even more is that I can understand why she didn't take it, as, through a horrible quirk of fate, her one shot involved incredibly disfiguring surgery and the loss of her arm," he wrote.
However Ms Ainscough's family rejected this claim in a statement released after her death.
"It has been speculated by people who have never met or treated Jess that, had she chosen to amputate her arm or undergo further conventional treatment, her chances of survival would have increased," the statement read. "Her treating oncologists do not agree with this uninformed view."
Chris Wark says he had communicated with Ms Ainscough over the years and was upset by the commentary surrounding her death.
"People have this flawed logic where they look at her and they say, 'Wow, alternative therapy doesn’t work; nutrition doesn't work. Because if it worked she would not have died'," he says.
"If one person is proof that that nutrition and alternative therapies don't work, then the 580,000 people who die of cancer each year in the US alone certainly proves that conventional therapies don't work."
Professor Tattersall says he still believes in miracles and has seen some incredible turnarounds in patients over the years, but is cautious of attributing those instances to any one thing.
"The cause of miracles is unknown but divine intervention is one, misdiagnosis another one," he says.
"Why do some patients do vastly better than other patients?"
"I think it’s fair to say we don’t know."
This story was updated on April 23 after Belle Gibson admitted she lied about having cancer.