Krebs Anhang Melanoma

 

[Joe Rozencwajg]

What is this natural, topical remedy?

Brassica Oleracea var Botrytis = Broccoli. Family of Brassicacea, formerly known as Cruciferacea or Mustards, family of cabbages, cauliflower, Brussels Sprouts.

According to John Boik, the Brassica family contains those carcinogenesis inhibitors specific to the cruciferous plants:

    Agents that block carcinogen activation: Aromatic isothicyanates and Glucosinolates (glucobrassin, glucotropaeolin)

    Agents that increase carcinogen detoxification: Aromatic isothiocyanates

    Agents blocking the action of tumour promoters: Aromatic isothiocyanates,   Dithiolethiones, Indoles, Phenols

    Supressing agents: Aromatic isothiocyanates

    Indole 3 Carbinol (I3C) causes apoptosis and prevents spread (3)

    I3C and Genistein increase the amount of BRCA 1 & 2 in cells preventing the transmission of damaged genetic material in next cellular generation (genetic relative deficiency).

    Sulforaphane inside the broccoli cells inhibits the oxidizing enzymes that damages DNA (New Scientist)

Sulforaphane is the most studied and best known broccoli-specific agent, also found in all the other Cruciferacae. The mechanisms of action are diverse and well studied. Even though many of those imply internal use of broccoli, I decided to use it locally so that an extremely high concentration could be achieved. Sulforaphane is an organosulfur substance that has anti-cancer, and antimicrobial properties in. The enzyme myrosinase transforms glucoraphanin, a glucosinolate, into sulforaphane upon damage to the plant, akin to the appearance of allicin when garlic is crushed. Young sprouts are particularly rich in glucoraphanin and can be used instead of the vegetable. I have actually started recommending using the sprouts as they are available year long and are easier to prepare than

the florets.

Vegetables (Cruciferacae) induce enzymes of xenobiotic metabolism and thereby accelerates the metabolic disposal of xenobiotics. Induction of phase II detoxication enzymes, such as quinone reductase and glutathione S-transferases in rodent tissues affords protection against carcinogens and other toxic compounds. Sulforaphane is the most potent inducer, and the presence

of oxygen on sulfur enhances potency. “Sulforaphane and its sulfide and sulfone analogues induced both quinone reductase and glutathione transferase activities in several mouse tissues.

The induction of detoxication enzymes by sulforaphane may be a significant component of the anticarcinogenic action of broccoli.”. It also induces apoptosis, “suicide” of cancer cells. And it has been shown to act on telomerase activity, which is an essential component of aging and cancer induction.

One study used local broccoli extract, but this was done with boiling and chemical extraction, making it a pharmaceutical substance rather than a natural one:

“Topical application of sulforaphane-rich extracts of 3-day-old broccoli sprouts up-regulated phase 2 enzymes in the mouse and human skin, protected against UVR-induced inflammation and oedema in mice, and reduced susceptibility to erythema arising from narrow-band 311-nm UVR in humans. In six human subjects (three males and three females, 28–53 years of age), the mean reduction in erythema across six doses of UVR (300–800 mJ/cm2 in 100 mJ/cm2increments) was 37.7% (range 8.37–78.1%; P = 0.025). This protection against a carcinogen in humans is catalytic

and long lasting.”

It also works by down-regulating the DNA methylation of genes controlling cancer occurrence, sulforaphane acting as HDAC or histone deacetylase, an epigenetic mechanism.

There are many studies that have investigated the mechanism of action of sulforaphane.

There is no doubt whatsoever that this is a potent tool in the treatment (and prevention) of all cancers.

Discussion

The purpose of using a topical application, as mentioned above, is to achieve a very high concentration of active components at the tumour location that would otherwise not be possible or practical. Even though those skin cancers are seen as local events, it is absolutely essential in my opinion to add the general approaches of lifestyle and nutritional changes, homeopathic and herbal general treatments according to every practitioner’s knowledge. The presence of a cancer, even caused by a clear local injury, means that the immune defence system has been overcome or bypassed; it has

to be restored to normal to avoid recurrences or the appearance of deeper, more aggressive pathologies. This method as presented here involves the patient in his treatment 100% as he fully controls what he is doing; it is also simple, cheap and effective while being pain free and not aggressive towards normal tissues. This fits perfectly with my personal philosophy of “Power to the people”.

We used the florets of the broccoli, but now have switched to the sprouts. Both contain the highest concentration of active substances, the sprouts being the most effective. The original recommendation was to juice them so that the cells are broken and the maximal amount of sulforaphane is produced. Some juicers cannot manage the small florets or the sprouts and many patients

do not have a juicer or cannot afford to buy one. One patient solved this problem by using a mortar and pestle until the plant was reduced to an extremely wet pulp with a pasty, mushy, consistence:

it worked very well and has worked well with other patients. Once the juice is extracted, if using a juicer, it is mixed with the dry pulp until a wet, almost dripping, “mush” is created. This is so that all the active substances are available. We tried to use the juice with gauze or cotton balls instead of the dry pulp; the activity was reduced to almost nil. I attribute this to adsorption on the gauze/cotton fibres. The “mush” is generously put on the lesion and covered with a cling film (saran wrap, glad wrap) that prevents the liquid from escaping and increases the local concentration.

It is then covered in any practical way possible, depending on the location of the BCC. Ideally, this should be changed every few hours to ensure a permanent saturation in active components.

This of course is not always possible. Leaving it overnight and changing the dressing during the night if waking up is a practical and effective method. The juice or mush has to be prepared fresh every time. Keeping it in the fridge is tempting; the activity of the preparation diminishes in time and might not be effective after a few hours, hence the need to change the application as often as practical with freshly prepared broccoli. The plant itself does not need to be freshly picked (active substances are mainly intracellular) or be organic: plain, cheap supermarket broccoli works very

well. If the lesion seems to burrow into the skin or to be covered with a thick layer that prevents contact with the juice, a short application of a slice of fresh garlic or some crushed one will solve that problem. Care should be taken not to leave the garlic too long as it has blistering properties (that is why we use it in this indication) and can cause pain. The good news is that it has also local anti-cancer properties and its use will not slow the treatment.

 

The different and multiple actions of the active components are active only on cancer cells and leave the normal tissues totally unharmed, and unstained. This very selective destruction allows the normal tissues to replace the dead cancerous cells “on the go” and prevents any scarring. There should be no pain and no bleeding unless the cancer cells have invaded locally a nerve or a vessel.

If any local pain appears, it will resolve without any interference and so far I have not received any report saying otherwise or needing any type of intervention. In one single case of scalp BCCs

in a gentleman in his sixties following multiple sunburns in adolescence and adulthood, the first application of broccoli gave the expected results. After the emergence of new lesions and repeated treatment, two phenomena emerged: first, the whole area became red and inflamed while the BCCs were quickly destroyed and replaced by ulcers, leading to the need to stop the treatment after about a week, followed by a full healing; second was the appearance of small BCCs in the same area during the treatment, which disappeared within a few days. The patient being otherwise completely healthy and with a very strong immune system, I interpret the reactions as a systemic assault of the immune system on the cancer cells that became recognisable as being pathological once weakened by the treatment. At the same time, the CSCs were stimulated (unproved assumption), started multiplying and were immediately destroyed by the combination of the local treatment and the immune defences. An experimental application of the broccoli on other spots not suspect of harbouring CSCs did not produce any reaction. This emphasizes the need for simultaneous immune-stimulant treatment as well as general core homeopathic treatment, which was the case for this patient.

Bleeding is controlled by local pressure, as no major vessel should be involved. This is an important difference and advantage over “black salves”, the escharotic treatments, the local chemotherapy, the local radiotherapy and of course surgery: all of them are not selective, destroy all the cells indiscriminately, are often painful and leave scars that are sometimes mutilating. For the same reasons, this treatment does not work on benign, non cancerous lesions (tried) and on warts (tried). Once a treatment has been started, it is recommended to continue until at least 3-4 weeks after the visible

or palpable lesion has disappeared, to insure each and every single cancerous cell has been destroyed. This time is a “guesstimate” of course, but also a safety measure. Last but certainly not least, it is simple and cheap, no special skills are needed except some help at the beginning to learn how to dress the spot when in an awkward location. And it cannot be patented, although I have seen some (expensive) creams and ointments containing broccoli extract: I challenge the real activity and the concentration of those preparations.

Inevitably, some lesions will be resistant to the topical treatment. Within the same line of reasoning, but without any clinical concrete results yet, I have suggested to replace the broccoli with either green tea or turmeric. The green tea could be a tea bag barely wetted so that no drinking tea is made but wet enough to have the fluid slowly escape; the turmeric should be of excellent quality

(which is always a problem) and made into a paste. That paste should be oily as curcumin, the active ingredient of turmeric, is lipid-soluble and will be more available if oil or fat is used. I suggest the use of coconut oil as it also has some anti-cancer properties; the drawback is that it becomes liquid at body temperature and might spill out of the local dressing. One option is also to rotate those three different plants so that as many active ingredients as possible are put into contact with the tumour.

Extending this practice to locally reachable lesions, I can imagine, but have not yet had the opportunity to do so, using this method for cervical cancers or lower rectal cancers. One theoretical advantage is that the active ingredients would also be absorbed using the same lymphatic and venous pathways that metastases use, allowing for their treatment with high local concentration, in parallel with a general treatment. A direct herbal treatment towards liver metastases or even liver cancer, bypassing the digestive system via the portal system, is also an extension of this method.

For the time being, I would not mix those three different herbs in one single “poultice” as I do not have any idea whether the ingredients would react, precipitate, become inactive or on the opposite would potentiate each other. I will leave this research to phytopharmacologists who have access to laboratory equipment.

Conclusion

A natural topical treatment for some skin cancers has been presented. It is simple, cheap, effective, based on research and scientific experimentation, painless and non-mutilating, and is deprived of side-effects. It totally involves the patient in his own care and in case of failure does not in any way prevent the application of other treatments. It should be the first choice, but also accompanied

by a general, deeper treatment. It was not tested on any skin melanoma.

 

[Lueder Jachens]

Malignant melanoma from the anthroposophical point of view (Original title: Neurodermitis im Kindesalter)

The physiological crossing phenomena of epidermal symbionts (melanocysts and Langerhans cells) relate to important delimiting functions of the organism.

A connection exists between melanoma development and sunlight, with the light representing the sum total of sensory impressions gained from the surrounding world. The particular characteristics

of a melanoma relate to the patient’s specific individual nature. Melanoma, a sense organ developing in the wrong place, relates to the eye. Crossing the conscious will with the light taken in from

outside (light-soul process) as a mission for our civilization provides the background for melanoma as a disease of our time. Apart from resection, the most important measure for prevention and

treatment of melanoma is treatment with Viscum album.

The incidence of malignant melanoma has shown a steep increase in the white population worldwide over the last 40 years; it is the tumour with the highest rate of increase. Even on its own this fact

makes melanoma a disease of our time. A closer look at the characteristics of this skin condition suggests that it has something to do with our modern lifestyle, and indeed with the spirit of our age.

Below, the physiology of epidermal symbionts (melanocytes and Langerhans’ cells), characteristics of melanoma and the character of the melanoma patient will be considered in some detail to arrive

at the essential image of malignant melanoma and at treatment.

Physiology of epidermal symbionts

With melanoma the malignant tumour of pigment cells (melanocytes), it is helpful to make a closer study of their origin and physiology. Melanocytes are of neuroectodermal origin; from the 8th week

of pregnancy, their precursors (melanoblasts) migrate through the mesenchyme dorsoventrally from the neural crest. Their route corresponds to the Blaschko lines, the paticular form of which is partly

determined by longitudinal growth of the embryo. In about the 12th week, the melanoblasts have reached the dermis and now colonize the basal layer in the epidermis. Here they live in community

with the keratinocytes, hence the term “epidermal symbiont”.

The fully differentiated melanocytes are positioned directly on the basal membrane and thus below the cell nuclei of the lowest keratinocyte layer in the basal layer.

Seen from above, the isolated melanocytes are in approximately hexagonal relative positions, one melanocyte providing pigment for 36 keratinocytes (functional epidermal melanin unit).

Being a symbiontic dendritic cell, the melanocyte has numerous branches (dendrites) for “filling up” “its” keratinocytes with melanin. The keratinocytes put the melanin on the side that faces the light,

to act like a sunscreen in protecting the nucleus from UV radiation.

1,000–2,000 melanocytes thus come to lie in a square millimetre of skin. The weight of all melanocytes together in a human being is c. 1.5 g. What we see here is a powerful and penetrating ordering

form principle. On the other hand, matter principles take hold of the melanocyte once melanin production starts; “the melanocyte must be seen as a unicellular gland, as it were”

Summing up, we may say that the boundary function which the organism as a whole assigns to melanocytes in the skin consists in responding to bright sunlight from without with material substance

from within (the blackness of melanin). Light, on the other hand, is a vehicle for cosmic form principles. The situation is immediately apparent in the wrinkles caused by chronic light damage –

the form principles of sunlight draw lines and furrows in the skin. Form principle from without thus activates matter within.

With melanoma it is important to look at Langerhans’ cells as well as melanocytes, as immunological processes play an important role in that condition.

Langerhans’ cells are also epidermal symbionts; from the 4th embryonic month they reach the epidermis via the blood, forming the most peripheral outpost of the immune system in the prickle cell layer.

Following contact with an antigen from outside, they leave the epidermis and migrate via the afferent lymph to a lymph node where they initiate the specific immune response.

With Langerhans’ cells, the boundary function of the organism thus consists in responding to a substance from outside (e. g. viral or bacterial antigens, contact allergens) by passing on information (light) to the inner organism. It is only secondarily and later in time that matter is set in motion from inside in the T cell-mediated immune response (contact eczema as an allergic reaction of the delayed type).

Comparison of melanocytes and Langerhans’ cells in terms of threefoldness in the organism as a whole shows that by origin the melanocyte is a nerve cell which as a “unicellular gland” is given metabolic function. Langerhans’ cells derive from bone marrow and are blood cells given sensory function in the skin. The polar opposite characteristics can be summarized as follows:

Delimitation by crossing Ontogenesis and function of melanocyte and Langerhans’ cell repeatedly show the phenomenon of crossing. The direction of migration at the embryonic stage is parallel to the embryo’s surface and from dorsal to ventral for melanocytes. It is crossed by the precursors of Langerhans’ cells moving centrifugally from bone marrow to prickly cell layer. A second crossing comes because of the difference in change of origin and function.

The melanocyte was a nerve cell and is then involved in anabolism; the Langerhans’ cell was a blood cell -blood is representative of metabolism- and gains sensory function. Finally the difference

in the way the two kinds of cells perform their delimiting function may also be seen imaginatively as a cross - the melanocyte responds to light from without with matter from inside; the Langerhans’ cell responds to matter from outside with light directed inwards.

The crossing phenomenon is well known in neuroanatomy and neurophysiology. With sensations in the body, in the eyes and inner ear projected contralaterally in the cerebrum, the relevant nerve tracts must cross.

What do such crossings signify? “Due to them, sensations enter into a sphere which is separate from their area of origin. It is a sphere of higher consciousness ...

With the crossing, sensations connect with the human life of thought and ideas at the fields of projection, a life which on its part relates to these projections, but is not part of them”. The crossing of nerve tracts must thus be seen in conjunction with the human potential for rising from conscious awareness to self awareness.

Another aspect to the significance of the crossing is found if we consider the E (German E, sounds like “ay”) in eurythmy therapy. “The E fixes the I in the ether body”.

“We create the E by crossing the limbs, a point of contact arises. This contact makes us perceive our own body. In the E, the arms cross, you close yourself off from the surrounding world.

The sensation is: The world has done something to me. Touching myself in this gesture, I can keep myself upright in the face of this.” In sensory perception, the soul is given up to the outside world;

with the E, one faces it in self awareness. “We must make left and right intersect if we are to have an I.” Crossing the limbs when doing the eurythmy-therapy E we strengthen the basis for experience of self.

For the human form, the crossing is a specific form of movement, in the central nervous system we have the “E gesture in organic fixation”, a neuroanatomical fact as those nerve tracts cross. With the

epidermal symbionts, on the other hand, the crossing phenomena are at a purely functional level, and thus deep down in the unconscious, in the sphere where astral body and ether body work together.

They are connected with the I-organization and are ultimately created by it. The I effects the integrity of the human body; it watches over foreign and native. This function of the I has failed in the case of malignant melanoma, and the crossing situations we mentioned effect decompensation.

Characteristics of malignant melanoma

Below, characteristic phenomena of malignant melanoma will be described which we consider to be important pointers to the nature of this form of neoplasia. The aim is not to present the full picture;

this may be found in textbooks.

First let us consider the kind of individual who tends to develop melanoma. The tumour is seen mainly in white-skinned people. In a talk with workmen, R.S. spoke of white skin as reflecting the light and heat of the sun from the body surface, rather like a snow-clad surface does in winter. Light and heat are not taken in from outside but have to be generated inside. As a re

 

Migration in 3rd embryonic month from neural crest to basal layer

Nerve cell becomes unicellular gland

Light from outside matter from inside

Langerhans’ cell

Migration from 4th embryonic month from bone marrow to prickle cell layer

Blood cell becomes cell with sensory function

Matter from outside light (information) to inside

 

In the case of melanocytic naevi, the melanocytes are called naevus cells; these also derive from the neural crest, but are aggregated in nests. Naevus cells are spindle or star-shaped and may produce melanin in different ways. These naevi are congenital or acquired after birth.

The term junction naevus is used when the naevus cells are in the region of transition from epidermis to corium in the epidermis.

If there are naevus cell nests in the epidermis and the corium, the naevus is a compound one. Dermal naevi are skin-coloured nodules, with the naevus cell nests exclusively in the corium.

When a melanocytic naevus loses its form principle, a dysplastic naevus with macroscopic signs develops with incident-light microscopic and histological signs of atypical changes. The macroscopic

signs show a diameter > 5 mm, asymmetry, irregular pigmentation and irregular margins. The above pigmentation phenomena in the skin thus range from normal tanning, which shows great, ordering form principles, to the dysplastic naevus where emancipation of the cellular principle is to the fore; this can be shown in diagrammatic form

Taking the above results from studies together with the pigmentation phenomena, we can say in general terms that a skin with numerous melanocytic naevi indicates exposure to external factors.

Exposure to the sun is only one of these; easy of access, it has been studied intensively. An analogy for the origin of melanocytic naevi would be a tray evenly spread with gravel. Some impact causes the stones to cluster. With actinic lentigines and melanocytic naevi as skin “imperfections”, the melanocytes indicate regression of the ordering form principle; they are like degenerative phenomena in the benign range.

The study where statistical means were used to show melanoma risk factors in the German-speaking countries (16) offers further interesting information:

• Particular occupations or branches of industry do not change the risk.

• In occupations with exposition to sun the risk is definitely increased.

• Blue-collar workers have a reduced risk; clerical workers a slightly elevated risk; qualified white-collar workers a greatly increased risk; the highest risk was found among the self-employed.

This fits in with the observation that malignant melanomas occur particularly in middle age (age meridian of 53 years). This is the time when people face many demands from and obligations to their surroundings which have the potential to cumulate in stress. The family has been established, the children are at school or university; a house has been built and must still be paid for.

At work, responsibility has been assumed; the individual is at the peak of his professional career. He has an honorary post or two. The higher incidence of melanoma at this age indicates that factors other than sun exposure are also involved; they may be subsumed under the title “foreign form principles from outside”

A disposition for melanoma may also be partly genetic in origin, with c. 10% of all melanomas showing increased incidence in families. R.S. and Ita Wegman generally ascribed hereditary dispositions to the I-organization being unable to integrate normally in the organism as a whole. Another characteristic melanoma phenomenon is association with other tumours.

It is not uncommon for melanoma patients to develop further primary melanomas. “Multiple melanomas are particularly frequent in patients with dysplastic naevus cell naevi”. The incidence of

non-melanocytic tumours in melanoma patients does not go beyond the general level, though breast cancer is the most frequent second tumour in other organ systems. 651 women among 9034 melanoma patients developed a second tumour, in 104 of them breast cancer. This is interesting if we consider that the mammary gland is an organ of the subcutis and breast cancer therefore a tumor of the skin in the wider sense.

Malignant melanoma and breast cancer are both tumours of the skin as an organ, except that the latter derives from the skin’s deepest and the former from its uppermost layer. Melanoma and breast cancer have other things in common, too. Late metastases 10 or more years after surgical removal of the primary tumour

Benign phenomena of skin pigmentation.

Equilibrium between the organism’s own form principles from within and foreign form principles from outside form principle - order normal tanephelids lentigo

simplex

lentigo

senilis

melanocytic

naevi

dysplastic

naevi

cellular

principle

- own aims is one of these, and the specific personality of patients also shows similarities.

A patient’s observation that a naevus has grown has been statistically identified as a sign of risk. Even the vague statement that a blemish has changed or is itching, or that “something is not right” with it, should be taken seriously. The skin as organ of the I-organization and of conscious awareness makes it possible for a tumour process to rise from the darkness of subconscious organic life into the twilight of dream-like bodily sensation, metaphorically knocking on the door of daytime consciousness.

The natural location of melanocytes determines the site where the melanoma begins to grow. This is the basal layer, the vital stratum in the epidermis. A special feature seen only with melanoma and no other tumour is that growth is exclusively planar for years, spreading horizontally and only intraepidermally (60 -75% of melanomas). This reflects the form principle to which they are initially still subject and which keeps them in the epidermis. Growth in the vertical direction is secondary, causing a nodule to develop. Significantly, primary melanomas may also occur in other organs with surface boundaries - the mucosa, the chorion in the eye and the meninges.

Finally let us consider the special features of metastazation with melanoma. Progressive metastazation goes from skin metastases in the immediate vicinity of the primary tumour (satellite metastases) via skin metastases (usually subcutaneous) along the route from primary tumour to the nearest lymph node (transit metastases) to regional lymph node metastases and finally haematogenic metastazation. The latter does remarkably often affect regions where the organism is in contact with the outside world skin, lungs, liver, brain. Organs with boundary surfaces may also be affected - heart,lung, tonsils, duodenum, small intestine, kidneys. It is interesting to note that melanoma metastases are always melanotic in the neurosensory system and often amelanotic in metabolism and limbs.

The melanoma patient’s personality

Following the evolution of cancer in different patients, the physician will again and again come to the burning question: Are there particular features which one sees more frequently in cancer patients? Do certain personality and biographical characteristics suggest such a thing as a “cancer psyche”? Is there a specific melanoma-patient personality? In the author’s opinion, the words of R.S. in two lectures he gave provide a definite answer to this. In Prague in 1911 he challenged his audience to look “everywhere in the organism for material processes which correspond to everything that happens in the soul”. It is a matter of really finding “such correspondences between psychic processes and physiological processes in the organism”. He went on to say that in this sense, thinking goes hand in hand with salts forming, feeling with the modification of swollen conditions, and the unconscious will with the generation of heat. Steiner’s challenge to look at both psychic and physiological aspects can be transformed and extended into looking for the way a pathological organic process correlates with processes in the psyche. A start has been made with neurodermatitis and psoriasis. The question arose as to how it is possible to find markedly polar and relatively reliable correspondences between the physical situation with two skin conditions and the inner life of the people who have those conditions. The reason is that the skin is near and dear to us in mind and spirit.

Following Aristotle, Thomas Aquinas said that the soul is the “principle for existence” and the “ground and basis for life”, its “configuring form” and “reality”. According to him, the form principle comes from the soul sphere, and “the more noble a form, the more is it able to govern bodily matter”. Every physician can see the noble nature of the human skin; we can conclude from this that it is particularly closely connected with the soul.

R.S. gave a detailed description of how the human spirit, the I, lives in the soul. Referring to the skin, he said: “In human beings, it is particularly the organs in the periphery which the I penetrates fully, giving them their configuration”. We may thus call the skin an organ of the I or self. This is the reason why pathological processes in the skin can be specifically and reliably found also at the level of soul and spirit.

From a lecture R.S. 1924, describing the interaction between astral body and ether body in man, we gain further insight for our question. The astral body has the tendency to make human beings ill.

The ether body develops life in them; the astral body reduces it. Human feeling is based on the constant to and fro in an unstable equilibrium between etheric and astral. Inflammatory changes occur when the astral body is too powerful; proliferation results when the ether body is too powerful. Considering the above-mentioned connection between feeling on the one hand and interaction of astral body and ether body on the other,

R.S. said: “The human life of feeling is simply mirroring the life of the disease in the soul. - An unstable equilibrium exists all the time in our perfectly normal life of feeling between proliferations and inflammatory processes.” This insight can provide a rational basis for perceiving the melanoma patient’s personality. Human beings only perceive things for which they are conceptually prepared. Such work to gain insight must therefore be done. A physician who does not think that there is a “cancer psyche” and melanoma personality will also be unable to see these in his patients. R.S. concluded: “This makes it possible that in the human life of feeling we are able altogether to see extraordinarily much of what disease processes represent. If one can observe such things a long time before physical diagnosis of the disease is possible, it is possible to establish the future illness from the fact that the life of feeling is no longer functioning properly. The illness is but an abnormal life of feeling ... And essentially it is simply not possible to develop a feeling for making a diagnosis unless one has a good eye for the inner life of human beings.”

The basic situation of melanoma patients, in body and soul, is characterized as the danger of losing the balance between outer light and inner light. The boundary between inner and outer cannot be maintained in body and soul, and ultimately foreign principles enter into the organism. It is not surprising, then, to find the following personality traits with marked frequency in melanoma patients. They are pleasant, correct in behaviour, adapted and over adapted to the social environment, and easily guided by their physician. In a dermatological unit, physicians and nurses will often remember melanoma patients for a long time because they were so pleasant. Following the death of a melanoma patient, the author repeatedly heard nurses say: “It always strikes the wrong people.” Other characteristics are being emotionally thin-skinned, sensitive, with a rich inner life.

These patients do not use their elbows, psychologically speaking; one will even find a tendency to be proverbially “blue-eyed” on occasion. Above, we considered the constellation of powers behind blue eyes in the physical sense - the blood having less impulse power to drive “blackness” to the periphery and as far as the eyes. This physical cum etheric situation is easily “translated” into soul terms in that the proverbially blue-eyed tend to protect themselves less, are less likely to reflect much on measures they’ll take on entering into a particular situation. In this sense, its is quite alien to these patients to “plot and scheme” to the detriment of others.

The pigmented skin might be the physical correlate of “putting up a screen”. Being open to the world means that melanoma patients are often prepared to listen to the concerns voiced by others, and also have a heart for the problems of other nations. They will sometimes be intensely involved socially and even take on more honorary positions than they are able to cope with.

The story of Thomas A. Dooley (born 1927) who died of malignant melanoma in 1961 may serve as an example for the specific inner leanings of melanoma patients.

Dooley was a citizen of the U.S. of Irish origin. In 1954 (at the age of 27!) a physician in the US Navy was sent to supervise the evacuation of refugees from communist N. Vietnam to free S. Vietnam, and prevent epidemics from developing. He set up a tented camp for 15,000 refugees, with all sanitary installations and the necessary administrative arrangements; later on there were

3 camps for a total of 30,000 refugees. He worked 14 or 15 hours a day, seeing patients and operating. When on leave he went on lecture tours of North America, collecting money for MEDICO,

an organization he had established in 1958.

This became one of the most significant humanitarian aid organizations in the 20th century. Dooley wrote a detailed report on his work in Indochina. Details of his personal experiences taken from this are given below.

His constant fear was that he might be suddenly posted elsewhere and that his successor, however able, might not feel for the refugees and their troubles as he did. He and his colleagues always suffered the torment of feeling inadequate, unable to smooth things over even superficially. There was nowhere for them to go to escape from the unimaginable misery around them. A free afternoon would bring a kind of guilt feeling, spoiling their pleasure in the brief respite. Between the end of August 1954 and mid-May 1955 he lost a third of his body weight. Daily routine went on uninterruptedly, in spite of several bouts of malaria, infection with four different kinds of worms, and a very unpleasant skin eruption. The constant drain on his energies and nerves did not worry him. The moral conflicts were much harder to bear. His conscience drove him to do more and more to prevent himself from falling into doubt and despair. A kind of being-at-school complex of never doing enough tormented him. They were always taken from one extreme to another.

Now and then they would feel relaxed and well for a few hours, but then they would realize, with sudden shock and pain, that they were living on the edge of hell. A colleague called Peter kept telling him not to take things to heart so much. Dooley was often torn between going to see a patient in the mountains whom no one else was able to treat, or leaving that man to himself and performing his duties in the hospital.

Peter would tell him to stay where he belonged, and that he could not be everywhere at once. He would reply that he could not let the man die; it was a moral responsibility.

In the late summer of 1959, Dooley fell off his bicycle and lacerated the right chest wall. Soon after this, a malignant melanoma with regional lymph node involvement developed in that side.

It was surgically removed in September 1959. Dooley died 17 months later from the sequels of metastazation.

In dermatological practice you will again and again see patients who are capable of great empathy. This is particularly evident in the above example. The empathy must, however, be encompassed by the I. It must be given order and form, a clearly defined place in the individual’s personality and biography, so that it does not lead to giving oneself up completely. With melanoma patients there is a danger of excessive empathy endangering the boundaries of the psyche. Foreign principles can then break in.

The essential nature of malignant melanoma

The whole periphery of the human organism is predestined to be sense organ. The great variety of sense organ is due to the fact that each particular sense organ serves perception of a particular sensory quality. “The skin really makes the human being as a whole into a sense organ”. The skin is, however, only made to perceive a particular sensory quality and far from all of them, e.g. not light. It is the eye made for the light.

R.S. used the eye, the “most radical sensory organization”, as an example for describing the development of a sense organ. “It is really created half from outside; it is integrated into the organism.

The organism on its part ... leaves free the eye cavity. The eye is placed in this. This indicates that the development of the eye mainly involves processes from outside the human being. The human being merely receives it. With a sense organ as striking as the eye we can say that a foreign body is integrated into the human organism”. R.S. made a blackboard sketch of this

He then considered the way the four bodies relate to each other in the eye. “Everything placed in there, and in the case of the eye it actually is still partly etheric and not merely physical, is encompassed by the astral body and the I-organization which in the eye are actually as far as possible emancipated from the physical and the etheric.” In the central human being, e.g. in the internal organs or in muscle, the four bodies are intimately brought together. “With the eye, the situation is that I and astral body are closely bound together, and in the same way the other two are intensively bound up with each other. A loose affinity exists between ether body and astral body. This situation exists only in the eye”.

R.S. also sketched this.

In another lecture, given to members of the medical profession, R.S. described how sense organs can “only develop in the right way through the warmth and air organism in that the fluid organism and the solid organism act against it, and we have a resultant of components. This means that it is necessary for us to look at the relationship between physical organism, in so far as it comes to repression in metabolism, for instance, and the sculpting organism, in so far as this comes to expression in the neurosensory system. We must consider, as it were, how metabolism lets something ray out, with matter taken in a radial direction, and how the matter is the sculpted in the organs by the principle brought to it from the neurosensory system”. This can be shown in schematic form.

It should be noted in this context that sunlight belongs at the top in as it moves etherically through the air organism. The “resultant of components” we are here concerned with has been described elsewhere by R.S. as “cross-over relationship” and “relationship in the growth of powers”. When melanoma develops, the relationship of component powers is changed due to excessive sunlight and other impressions from the human environment. In his lectures, R.S. would often speak of a tumour being a sense organ developing in the wrong place. In the case of malignant melanoma and the role which sunlight plays in its genesis, one immediately thinks of a relationship to the eye. Using Steiner’s idea of the tumour as a dislocated sensory process we can thus say that malignant melanoma

is a pathological tendency in the organism to create an eye in the skin.

Pathologist Peter Ries of Hamelin, Germany, pointed out that there is a morphological similarity between the pupil of the eye with its surrounding iris and the superficially spreading melanoma

with central regression. In both cases, pigmented cellular structures lie radially around a hole!

For greater understanding of the processes which in the case of malignant melanoma lead to a sense organ developing in the wrong place, let us take a closer look at some aspects of the organism’s way of dealing with light. R.S. spoke of human beings being able to produce “original light” in their organism. “This inner light production goes to meet the influence of external light. With regard

to the upper human being we are made in such a way that external light and inner light act against each other in interplay, and the very essence of our organization rests on the fact that where these two, external light and inner light, are meant to work together, we are able to prevent them from merging, keeping them apart, so that they only act on one another but do not unite. As we face external light, be it through the eye, be it through the skin, a screen is set up everywhere in the human being between the inner, original oOrganization of eye.

Developmental process (based on a drawing by R.S.).

Development of sense organ.

I - in warmth organism

astral body - body in air organism

ether body – in fluid organism physical body

physical body - in solid organism

– sculpted form metabolic system

– radial form of matter light in us and the light that influences us from outside.”

(Figures 1 and 2 reflect this.)

We may therefore sum up and round off. The eye is the specific sense organ for light; here external light is permitted to overcome the body’s boundary and, though outside world, continue on

into the inner organism.

R.S. also referred to sense organs as “bays” ext. the organism from the outside world.

The human skin reacts to light by producing pigment; as we have seen, it takes in light only in the qualitative sense and not in the physical sense, which the eye does. In the light metabolism of the human organism, the generation of inner light is stimulated by external light. Inner light, being light ether, is content of the ether body. The light ether lives in the air organism and it is through this that the astral body incarnates.

A stream of light pours into the inner human being via the upper human being, when external light (= light ether) has been taken in as quality by the sense organs and the skin. In the upper human being, light creates thought: “Thought arises from light. Thought weaves in the light”. In the lower human being the form principle active in the light ether lets boundaries develop, fully forming

out the whole human being down to the level of individual organs.

Considering the relationship between light and human existence in the physical body as well as in soul and spirit, and the role which sunlight plays in melanoma development, the question arises if people relate to light in a particular way today. An answer may be found from anthroposophy as a whole in so far as it makes it clear to modern people that it is now necessary for human beings to oppose the centripetal stream of incoming sensory impressions, of light, with inner activity and the will to gain insight, which move centrifugally. R.S.: “We must grow aware of a much more subtle relationship to the outside world, which means that with regard to our ether body, something is happening which must come more and more to conscious awareness, similar to the breathing process. In breathing, we inhale fresh oxygen and exhale useless carbon dioxide air.

A similar process exists in our sensory perceptions. - We ... must develop the subtle aspects in dealing with the world so that as we take that world in we have not only sensory perception but also something which is of the spirit. - World thoughts influence us from without, and the human will acts from inside to outside. – We must come to feel how the will acts through the eyes, and how the activity of the senses does indeed merge into our passivity, so that world thoughts cross with human will.

—We must ... if we make light the general representative of sensory perception, rise to the thought that light has soul”. Everything coming to us, to our senses, from the human environment is light.

R.S. spoke of a “light-soul process” characteristic of the Michaelic age, with the soul passing through cosmic space on the wings of light.

There seems to be an evident connection between the crossing of world thoughts and human will which R.S. said was the mission of our present civilization, and the crossing phenomenon seen with epidermal symbionts.

The connection may be considered to lie in the fact that a wisdom reveals itself in the phenomena of those symbionts which lies dormant deep down in the unconscious human organism, waiting to be brought to light of day in that process of civilization.

The words R.S. gave as spoken by Michael, the spirit of our age, about modern humanity point to this:

“The power of the spirit sun shines on their souls; the Christ is at work; but they are not able to heed this. Power of the spiritual soul is active in the body; it does not yet want to come to the soul ”.

This power of the spiritual soul unfolds in the light-soul process as human beings compel their will towards perception, to deliver the world thought from the sense-perceptible world.

One example of the many such efforts being made in our present civilization is Goethean natural science. If people fail, however, to connect the will with sensory perception, so that the power of the spiritual soul is not elevated in the body, then that soul will cause morbidity. We are thus able to see a light-soul process not brought to realization as a possible cause for development of malignant tumours and especially melanomas.

Feeling plays an important role when world thoughts cross with the human will consciously brought into play on the soul’s boundary. From the midst of feeling comes the individual relationship between thoughts from without and will from within, a relationship which is different for everyone. Developing a feeling for both spheres we develop the ability to find always the right measure.

In the case of Thomas A. Dooley it is evident that a feeling for his own needs and the necessity for protecting himself were not adequately met. The needs of others around him touched him too deeply, on the other hand.

R.S. described the conditions for life in soul and spirit in the present Michaelic age in more detail, saying that anything which has developed in the past, God’s work, must only influence the human I from the environment. Freedom in human inner life must be developed in our time but is only guaranteed if the impulse from the human environment, from nature, the work of divine spirits, extends to the I and does not influence the ether body and the physical body. Sunlight is the influence of something evolved in the past; a tendency for melanoma develops if we allow it to act on our physical body and ether body and not at all or too little on the I.

The world thought in sunlight must only influence the conscious human will; this is a condition with the light-soul process, a process which demands freedom in human inner life.

In the lecture where he described the crossing of the world thought with the human will in the light-soul process, R.S. gave an example for will activity. This is the fading after-image when the eye has perceived something.

This after-image is an objective fact in the world ether. It is interesting to note that patients undergoing chemotherapy lose the ability to see complementary colours in the after-image. This reveals the nature of chemotherapy.

The connections established between sunlight and melanoma development show that with melanoma, the tumour process is in two phases. In the first phase, foreign principles from the human environment irrupt into the organism; this is a dynamic process with no physical correlate. In the second phase we get the catastrophe of form due to emancipation of the cellular principle; the tumour process becomes physical. In the first phase the healthy relationship between the four bodies in the skin is upset by sunburn, especially in childhood and youth. I and astral body live in the light of the senses; this gains too much power in its centripetal activity.

It overcomes the body’s boundary, irrupts into the organism and creates a bay

R.S. went into more detail in a lecture given to members of the medical profession. “I-organization and astral organization getting too powerful in the neurosensory organism someone drive this whole organization into the organization of metabolism and limbs”. This leads to the beginnings of a sense organ in the wrong place and to carcinoma. Applied to melanoma this means that the higher bodies are too strongly active in the light, damaging the melanocytes which are an element in metabolism (“unicellular gland”) in a functional sense that goes beyond the physical. This describes the process immediately as sunburn develops; a later sequel is loosening of the connecting between higher and lower bodies, as described for the physiological condition in the eye. This pathologically loosened the connection between the four bodies is the cause of the increased melanoma risk. It persists for decades with no symptoms. It needs biographical crises, professional overwork and strokes of destiny that are too much for the delicate soul and constitution to bring on phase 2, with the tumour process becoming manifest. The loosening of the bond between higher and lower bodies then causes the connection between the body’s own form principle and the matter principle to be broken in the melanocyte. The cellular principle, in which the physical body is active, loses its power to maintain form, a power subject to the impulses of the higher bodies.

A dynamic fact, fills up with melanoma cells and can now be measured as a vertical tumour diameter (Breslow index). (The etheric bay will, however, always be greater in dimension that the tumour itself, comparable to a crystal and the lustre around it.)

Interestingly, Dr Dooley had a laceration preceding the melanoma. In dermatological practice, one hears patients say again and again that the melanoma was preceded by a mechanical trauma. R.S. also gave “mechanical insult”, “prolonged exposure to high temperatures or a burn” as examples of triggers for a “tendency to develop a sense organ” in the wrong place and thus tumour development. He spoke of a breast being struck as the origin of breast cancer. This means a centripetal action from outside towards the inner organism, “which makes the astral body appear most powerfully in the site, whereas it is normally absorbed by the ether body. When the astral body suddenly shows itself in the site, it appears ... in a glow of light, as if burning. When it shows itself

like this we have a tendency to develop a sensory effect in the site, a carcinoma develops”.

Hyperergic phenomena such as rhinitis and allergic conjunctivitis, urticaria, polymorphic light dermatitis, eosinophilia, penicillin and iodine allergy are common in the history leading up to melanoma. When a member of the audience in R.S.’s discussions with workmen asked him about hayfever, being a sufferer, the answer was: “No one whose whole body has a disposition from the beginning to develop hardening of the arteries is likely to get hayfever, for hayfever is the very opposite of hardening of the arteries. ... Your hayfever is a kind of valve to prevent sclerosis”. Sclerosis and tumour are cold conditions; hyperergia is a warm, inflammatory process with emphasis on blood impulses and may therefore be considered an attempt at self healing if there is a tumour disposition.

This is what R.S. meant by “valve”. The author is aware that many aspects of malignant melanoma (personality, developing a sense organ in the wrong place) also apply to any other tumour process.

Unlike practically all other tumours, melanoma has the special feature that the phenomena are superficial in the truest sense of the word and therefore apparent.

Melanoma truly is “no marginal phenomenon in oncology, nor a special case, however interesting medically, but in many respects absolutely exemplary for cancer growth in general”(50), in the terms of both natural science and the anthroposophical philosophy of man. With any tumour you have patients who have none of the relevant risk factors. Melanoma patients who have avoided the sun all their life, being fair-skinned, may also have no stress in their occupational or private lives.

Patients like these may make physicians think that one does not get the number of melanoma patients among the part of the Central European population who are exposed to intensive UV radiation on the shores of the Mediterranean or even in Far Eastern countries which one would expect.

Development of melanoma,

phase 1. foreign form

principle

in sunlight

body’s own

form

principles

Fig. 8

proportion of melanoma cases (with regard e. g. to absence of UV exposure) are found in parts of the population who handle themselves and their environment with great awareness; placed outside the risk group in compensation, as it were. R.S. spoke of “certain disease potentials covering whole broad territories”;

considering it possible that a disease may manifest if not in one place then in another within a large population if the times demand it. The question is, therefore, if there are perhaps melanoma patients who, being sensitive and having fine minds, take on the tumour tendency of an age on behalf of others, as it were. Considering that R.S. asked us to grasp carcinoma as a sense organ in the wrong place, Christa-Johanna Bub-Jachens posed the question in this journal two years ago: What does a carcinoma as a sense organ sense? Her answer: “Might it not be the case that the carcinoma perceives the materialistic outside world, the materialistic emergency state of today? As the eye is created by the light for the light, so carcinoma as catastrophe of form may be created by materialism as a spiritual catastrophe. In that case, carcinoma would be a kind of image of humanity’s spiritual need, its function being to perceive this need”. Surely this applies particularly in the case of malignant melanoma.Prevention and treatment

If there is a melanoma disposition, one preventive measure is to avoid too much sunlight. A watchful eye must also be kept on all other influences and demands coming from outside in everyday life and the biography, lest the right measure be exceeded. Sunscreen preparations are generally assumed to prevent epithelial skin tumours; but a number of epidemiological studies in recent years have cast some doubt on this.

According to them, the fact that the epidermis can no longer produce natural photoprotection when sunscreen has been applied is a negative aspect. Patients should therefore be advised to use textiles to keep off the sun and common sense in gaining a tan, observing the right measure and necessary time.

Endogenous protection can consist in efforts to do justice to the light, the sensory impressions and all demands that life brings. Ralph Waldo Emerson said that heaven is the eyes’ daily bread.

We may add the words of Angelus Silesius: “Bread alone does not feed us; what feeds us in the bread is God’s eternal word, is life and is spirit.” This spirit which confers life is the “world thinking”, the world thought which needs effort of human will to deliver it from sensory impressions. This “will of humanity”(45), which must work on the sensory impressions, makes human beings more resistant to the irruption of foreign principles. If a patient asks how he can protect himself from the sun on a journey to Greece, we can say, therefore, that he should take along a good book on Greek temples and his diary. Melanoma prevention in this sense consists in perceiving the architectural idea of the Greek temple in the dazzling sun and working through what one has seen by putting it in one’s diary at night.

The first measure when macroscopic and incident light microscopic diagnosis suggest the possibility of primary malignant melanoma is surgery. Major studies done in the early 1990s have shown that a large safety margin with surgical removal and general anaesthesia offer no advantages. Today’s recommended safety margins are so small that it is often possible to have daysurgery and local anaesthesia. Aggressive oncological treatments for metastasizing malignant melanoma continue to be unsatisfactory as they do not extend life at all, yet seriously reduce quality of life. Only interferon has given some results, often with severe side effects.

In the natural world we find the process corresponding to malignant melanoma development in mistletoe (Viscum alba).

Mistletoe grows like a parasite on trees, separating itself from the forces of the earth and moving closer to the imponderable light and warmth which stream to the earth from the cosmos.

This gives mistletoe a phosphor-like action with a tendency to flower and fruit development and this addresses itself directly to the “bay”. The plant is therefore in a position to compensate the inadequate activity of the higher bodies in the warmth, light and air organism directed towards the fluid and solid organism. The many unusual characteristics of mistletoe, which emancipates itself from the normal laws of plant life, also make it medicinal.

The rhythm of its life through the seasons is the inverse of that of other plants. It flowers and fruits in winter when (at least on broad-leaved trees) it is exposed to the winter sun once the leaves have dropped in autumn.

On the other hand the foliage protects mistletoe from the summer sun. Pine has an inner connection with light and warmth qualities.

Mistletoe grown on it (Viscum pini) is suitable for treating melanoma. The best results in mistletoe therapy for melanoma have been seen with pine-grown mistletoe.

If there is a disposition (numerous naevi, dysplastic naevi, family history), it is advisable to give a prophylactic course of Iscador P in spring and autumn. Prescribe Series 0, one ampoule s.c. under

the abdominal skin every second day in the morning, with 14 days interval after the first series. If surgery is required or a primary melanoma has been removed, inject one ampoule of Iscador P every second day (or 3x weekly), following

Series 0 with Series 1 and continuing the latter without interruption. If metastases develop, mistletoe treatment can be intensified by giving it i.v. -Iscador P, 1 mg- 20 mg, increasing with caution, in 250 ml of saline once a week over a period of c. 2 hours. Intolerance reactions are uncommon with this slow i.v. infusion.

Mistletoe treatment helps with the evolution of neoplastic disease and also benefits the patient’s general condition. Its comprehensive action, also on the psyche, is illustrated by the words of a patient who seven years after surgical removal of three primary melanomas developed a metastatic breast tumour. Asked what mistletoe treatment meant to her she said: “Mistletoe makes me feel positive about life; it stops me from drowning in misery. It maintains my humanity, so that I came well through chemotherapy and radiotherapy. I was able to live a normal life at work and in caring for my family, and overcome the whole crisis of tumour disease using mistletoe preparations from different manufacturers (Iscador, Helixor, Abnoba Viscum, Iscucin)!”

The many good results seen in anthroposophical hospitals and practices have recently been confirmed in a study run as a multicentre, comparative, epidemiological cohort study at Freiburg University Dermatological Hospital. 738 patients with malignant melanoma who had a high risk (Breslow index > 1.5 mm +/o. regional lymph node involvement) were followed up for at least 3 years.

381 patients treated with Iscador P were compared with 357 patients who did not have mistletoe treatment. The result is that prophylactic longterm mistletoe treatment following surgical removal of melanomas reduces the risk of dying of melanoma and improves the chances of tumour-free survival.

Metal therapy given in addition to mistletoe treatment can be helpful. Aurum met. prep. D10 (10x) trit. is recommended to mediate between inner and outer, above and below. Antimony in form of Stibium met. prep. D6 (6x) trit. or i.v. (10 ml once a week) stimulates boundary development and makes the organism “more compact”. Ferrum met. prep. D6 (6x) trit. strengthens the powers people need to face impressions coming from outside. Other medicines may complement the treatment. Quartz will on the one hand act to set limits, to configure, and on the other clear the organism’s periphery for the reception of sensory stimuli.

It is given by mouth in medium-high potency or s.c. (Quartz D60 = 60x) every 6–8 weeks if one wants the emphasis on configuration. Formica gives the power to bring back everything which threatens to drop out of the sphere of life as a whole. Red ant (Formica rufa) can be used by mouth in low dilution or as Formica D3 Formica D15 aa given s.c.

The liver as an internal organ is filled with principles taken wholly from the foreign world outside man. Exaggerating, we may call it a tumour in the physiological sphere. The liver of every melanoma patient therefore needs treatment to generally strengthen its function, using Hepatodoron tablets or Vitis comp. tablets. External applications to help the I-organization to intervene in the organism’s periphery are Solum oil massage or rubs (Wala) and oil-dispersion baths.

Eurythmy therapy is a great help in gradually transforming the melanoma patient’s special and one-sided aspects of the inner life, which are usually almost at conscious level, and his special constitutional nature.

As we have seen above, E is the most important vowel.

As to consonants, B helps to create boundary and inner space, G to practise resistance. To conclude this paper on malignant melanoma let us consider a verse given by

R.S. which can be a guide for melanoma patients, their physicians, therapists and nurses.

Light of the sun shines on darkness of matter; thus the spirit’s all-healing nature shines on soul’s darkness in my human existence.

When I reflect on its great power in real warmth of heart, its lustre fills me with its spirit-noontide-power.

 

 

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