In scientific circles, an N-of-1 trial is a clinical trial in which a single patient represents the entire investigation: a single case study.
Shortly after I was diagnosed with terminal cancer in 1991, my personal n of 1 experiment began; its outcomes have been closely chronicled for a quarter century.
No two cancers are exactly alike; neither are two patients. Our individual needs—physical, psychological and emotional—and cancer treatment regimens can vary widely; just like our responses to treatment and our unique journeys into survivorship.
The great thing is that, in the latter years since my diagnosis, cancer care has become more individualized, with new targeted agents and interventions matched to a patient’s unique molecular profile. As a result, new drugs are being developed for smaller populations of patients.
We are each an n of 1
At the time of my diagnosis of incurable chronic lymphocytic leukemia (CLL) I was given a choice between an experimental bone marrow transplant or ‘watchful waiting’—essentially waiting for the disease to make its first move (toward progression) and then reacting, aggressively.
Instead, I coined the term ‘proactive observation’ and, rather than sit back, I began my investigation as an intrepid n of 1. I learned to become comfortable with the concept of not pursuing immediate treatment. Over the years I learned ways to strengthen my immune system and increase my metabolic rate with: regular vigorous physical activity; stress reduction techniques; a plant-strong diet; restorative sleep; select supplementation; and a host of other evidence-based or minimally evidence-informed approaches to health creation.
We are each our own exclusive experiment in life, health, and illness.
I’ve closely tracked my integrative cancer care regimen over the years, including my conventional care and monitoring—regular physical exams, bone marrow biopsies, imaging and blood tests.
Without the help of conventional treatment of any kind I’ve achieved repeated remarkable clinical outcomes during my long course with CLL.
I cannot pinpoint the exact pathways in which my multi-modality regimen and lifestyle impacted my extensive, ‘incurable’ disease. Nor can I make assertions as to how you or anyone else should go about ‘curing’ his or her illness. However, at present, according to Harvard pathologists, my marrow is clear of all visible disease.
n of 1 is an important scientific construct. It will gain in acceptance and significance in the future as will individual high quality case reports that capture radical remissions. The peer-reviewed, published case report that captures the technical details of my informal N-of-1 experiment can be found here.
I am considered a poster child for this imminent N-of-1 movement. It is my intention through my book, this blog, and via additional educational and communication efforts, to ensure that this campaign takes flight.
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