United States Congress
Committee on Government Reform
Hearing on Fighting Prostate Cancer: Are We Doing Our Best?
September 23, 1999

Testimony of:

Jeremy R. Geffen, MD, FACP
Geffen Cancer Center and Research Institute
Vero Beach, FL

Good morning.

I am honored and privileged to be here today, and to have the opportunity to speak with you about a subject that I care deeply about; namely, the journey through cancer in general, and prostate cancer specifically.

Like so many others, I have been touched by this disease in many ways, including through members of my own family. I spent fourteen years studying and training to become a medical oncologist at some of the finest universities and medical centers in the United States, and have also been fortunate to have studied medical and spiritual traditions in other parts of the world. For the past ten years I have also had the privilege of serving as physician, guide, mentor, coach, and friend to thousands of cancer patients and their family members, many of whom were dealing with the often formidable challenges associated with prostate cancer.

Along the way I have learned one lesson, over and over and over again, that I believe lies at the heart of what patients and families experience on their journey through cancer. That lesson is very simple, yet profound, and it is this:

Cancer often challenges the mind, heart, and spirit of patients and their family members as deeply -- if not more deeply -- than it challenges the physical body.

Unfortunately -- even tragically -- this simple lesson is often overlooked in the compelling search for newer and better ways to diagnose and treat cancer.

The urgent drive to eradicate illness has caused western medicine -- which we are richly blessed to have -- to focus almost exclusively on the physical dimensions of disease, rather than on caring for the whole person who has the disease. And this is especially true in the field of oncology.

With respect to prostate cancer, for example, we speak of incidence and mortality rates; PSA screening programs; and Gleason Scores. We talk of radical versus nerve-sparing prostatectomies; external beam versus seed-implant radiation therapy; and simple versus total androgen-deprivation therapy. And, in recent years, we have also started to talk about the role of diet, nutrition, and alternative and complementary therapies in cancer prevention and treatment.

This is the language of prostate cancer, and it is the language that physicians, researchers, and legislators tend to use when we talk about where the field is today, and where it should be going in the future.

If we listen carefully to all of this language, however, and if we have the courage to really hear, we will notice something that is almost always glaring in its omission: namely, the mind, heart, and spirit of the men who are going through the nightmare of prostate cancer, and the spouses and family members who are going through it with them.

Make no mistake: aggressively pursuing all avenues of research in early diagnosis, prevention and treatment of cancer is a vitally important task. However, technological breakthroughs in science and medicine, no matter how breathtaking or spectacular, will never fully resolve the enormous spectrum of challenges encountered by people with cancer. And, as valuable as they are, neither will diets, herbs, vitamins, antioxidants, exercise programs, and other similar regimens. Focusing primarily on treating the physical body ignores the profoundly important mental, emotional, and spiritual dimensions of this disease, and it also ignores the important inner healing potential that lies within all of us.

Thus, as radical as it may seem, I have one simple message that I would like to bring to this committee.

I believe it is time for our medical and health care system to make a firm, uncompromising, and unwavering commitment to honor and embrace every single dimension of who we all are as human beings -- particularly in the care of people with cancer.

At our cancer center in Florida, we have implemented a unique program which -- along with high-tech, conventional cancer treatments -- is designed explicitly to accomplish this goal. The program, which has seven levels, addresses each and every aspect of the healing process that patients encounter on the journey through cancer.

Very briefly, the seven levels are as follows:

Level 1. Education and Information, which is designed to give patients answers to the urgent, pressing questions which they have about their disease and treatment options;

Level 2. Psychosocial Support, which focuses on the need and benefits of having a strong support network on the journey through cancer, as well as the journey through life;

Level 3. The Body as Garden, which encourages patients to think of their body as a garden that can be cultivated and nurtured, rather than as a machine that is simply to be "fixed" by the doctor. This level of the program also explores the vast array of alternative and complementary therapies which can help facilitate this process;

Level 4. Emotional Healing, which helps patients and family members deal with the difficult and at times overwhelming emotional challenges encountered on the journey through cancer;

Level 5. The Nature of Mind, which helps patients gain an understanding of how their thoughts and beliefs, and the meaning they give to events -- including cancer -- profoundly influences their day to day experience of life, and their treatment process;

Level 6. Life Assessment, which helps patients understand and connect more deeply to their life's deepest meaning and purpose, and to their most important goals and priorities for the coming year; and

Level 7. The Nature of Spirit, which teaches patients to connect with the non-physical, timeless, dimensionless, and profoundly healing spiritual aspect of life that we all share.

Years of experience have proven to me that these are the seven areas of care that all patients need -- in addition to the very best that high-tech, conventional medicine has to offer. Our challenge, and our opportunity, is to find a way to make them available to every man, woman and child in America who has cancer.

Thank you.