Review casts doubt on 20,000 treatment

An American doctor is under investigation over cancer treatment, writes Eithne Donnellan.

An American doctor is under investigation over cancer treatment, writes Eithne Donnellan.

The American-born doctor William Howard Porter has a chequered history.

He was in his 50s when he came to Ireland in the 1990s and, within a relatively short period, found himself before the courts charged with failing to keep up maintenance payments for his family in the US.

He was given a three-year suspended sentence at Loughrea District Court in November 1998 and advised to recommence work so that he could discharge some of the money he owed his family. The sum was over $1 million.

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He told the court he had left the United States "almost penniless", and admitted, "I am terrible with money and I apologise".

An eye surgeon, he had been struck off for "gross negligence" in California.

Upon his arrival in the Republic, he set about providing alternative therapies but did not register with the Medical Council.

He worked for a period at the East Clinic in Killaloe, Co Clare, with Dr Paschal Carmody, a GP who in recent weeks was struck off the medical register for professional misconduct.

More recently, he has started providing Cytoluminescent Therapy (CLT), a variant of photodynamic therapy (PDT), at other nearby premises. He targets cancer patients, with the cost per patient set at €20,000. According to his website, he is currently booked out.

However, a review of the benefits of CLT to 48 patients treated by Dr Porter in Killaloe in late 2002 and early 2003 casts doubts over the efficacy of the treatment. Six months after the laser treatment, which is followed by a period of self-administered oral medicine and illumination with infrared lamps at home, 17 of the patients were dead and many suffered after-effects.

The review, carried out by Dr Ralph Moss at the request of Dr Porter and published in a US medical journal called Integrative Cancer Therapies, said it was not possible to "categorically attribute any deaths to CLT" but it cautioned about its use.

Some patients, the review said, were of the impression the treatment enhanced their tumour progression or hastened death. "The author's conclusion is that CLT, delivered in the manner described in this article, has been ineffective for the great majority of those who were treated."

The review quoted Dr Porter as saying: "I haven't found any tumour that there hasn't been a favourable response to ... there seems to be a consistently favourable response to virtually every type of tumour that we've treated ... Truthfully, many people with advanced-stage cancers just seem to be carrying right on."

Most of the patients who were part of the review had advanced or recurrent cancer, and most had exhausted all conventional treatment options.

Dr Moss noted that the first 24 patients, apart from being administered CLT, were also put on an "immune modulation programme" by Dr Carmody. The second group of 24 did not get this and fared better. On this point, Dr Moss wrote: "One odd and disturbing occurrence is that 14 of the 17 patients who died within six months of initial CLT" were among the first group of 24. "This represents 82.4 per cent of all the deaths in the observation period." This was despite the fact that there were more patients with advanced cancer in the second group of 24 patients.

Dr Moss wrote: "A potential explanation for some after-effects is that the ancillary treatments given to set A (first 24 patients) during their week of initial treatment might have either been intrinsically harmful or have interacted in an unknown but deleterious way with CLT."

The review pointed out that some of the after-effects, which included nausea and diarrhoea as well as renal and liver failure, would not be unexpected in advanced cancer patients. Furthermore it said it was not possible at this time "to categorically attribute" any deaths to CLT.

But it said even the subjective impression of some respondents that CLT might have actually enhanced tumour progression or hastened death was serious. Dr Moss concluded: "In this cohort of 48 patients, a large proportion found CLT either worthless or harmful or died within a relatively short time of receiving it. This is a sobering conclusion, with implications for other attempts to use novel cancer treatments outside the context of traditional developmental channels and institutional constraints."

Dr Porter did not return calls from The Irish Times yesterday to discuss Dr Moss's findings. A message on his website said: "We currently cannot return phone calls or give personal e-mails responses. We do not at this time have the infrastructure in place to deal with the demand by people for places on our programme. We are, however, doing our utmost to make this treatment available at many clinics throughout the world."

The Medical Council has, on the basis of the Dr Moss review, reported Dr Porter to the Garda.