Mr Wright is a case dating back to 1957, in which a patient supposedly made a miraculous recovery via placebo, before relapsing straight-away upon discovering his treatment was a sham. Placebo researchers everywhere wish this case were true, but current research into the placebo effect throws the shadow of doubt on to this incredible story.
In 1957, Mr Wright was a patient in Long Beach California. He was found to have cancer and he was given just days to live. His tumours ‘were the size of oranges’ – inoperable, untreatable and terminal. Mr Wright had heard that some scientists had discovered that a horse serum (Krebiozen), was an effective cancer treatment. Despite, it not being an approved treatment, Mr Wright was committed and he eventually convinced his physician, Dr Philip West to give it to him.
Dr West injected Mr Wright on Friday afternoon and by the Monday after he was out of bed, looking much healthier and according to Dr West, his tumours ‘had melted like snowballs on a hot stove’.
Mr Wright continued to improve, until two months later, he read a medical report stating that the Krebiozen horse serum was completely ineffective. He immediately relapsed.
Faced with a rapidly deteriorating patient, Dr West told him not to believe what he read in the papers, and that he would inject him with ‘a new super-refined double strength’ version of Krebiozen. What Dr West didn’t mention, is that this was actually just an injection of saline, but to his astonishment, the tumours once more disappeared. Mr Wright appeared to recovered and was described as ‘a picture of health.’ The placebo treatment had worked.
Two months after, Mr Wright read another report definitely stating the worthlessness of Krebiozen as a cancer treatment. He once again succumbed to cancer and he was dead within two days.
Can the placebo effect cure cancer? – What’s the problem?
There are several issues with this remarkable case. The most prominent being that there is very little evidence that placebos can have any meaningful effect upon cancer. We’re not completely certain of why this is, but our bodies contain very few cancer-fighting substances, so there’s not much for the placebo effect to work with. [Read more about the placebo effect and cancer]
Another issue is the obvious ethical dilemma of a doctor lying to a patient and giving him a placebo instead of an active drug. Medicine was different in the fifties, it was more patriarchal and informed consent took a back seat. But in this case, the patient is remarkably well informed. It is him that suggests the Krebiozen to his doctor, and it is him that keeps up to date with the literature on the subject – although not well enough to know that he wasn’t getting ‘a new super-refined double strength’ version. It is generally thought that if placebos are ever accepted into conventional healthcare, it will be as open-label placebos, where the patient understands what they are taking. Some may argue, that deception is okay if it benefits the patient, but modern medicine is underpinned by trust. If doctors were known to routinely prescribe placebos instead of conventional medicines, the effects of conventional medicines may be diminished as people may expect them not to work so well and the doctor-patient relationship would be damaged.
So what was going on with Mr Wright?
There are several possibilities to consider:
- The case may not have been accurately reported:
Cases such as this, can often be subject to bias in reporting. Dr West, was writing about his own patient, from his own perspective. He has a vested interest in his case being published and becoming famous in the medical establishment of the time. I’m not saying that Dr West would deliberately mislead the public – although he did mislead Mr Wright – but the case and how it’s communicated may be heavily affected by his own biases.
- The placebo effect may have caused Mr Wright to feel an improvement, but not to actually have improved:
If we accept some inaccuracies in the case report, it is possible that Mr Wright may have experienced an improvement in symptoms that could be attributed to the placebo effect. However, he may not have experienced an improvement in his pathology.
- Mr Wright may have been misdiagnosed:
Mr Wright may have been misdiagnosed with cancer, or his doctor may have misjudged the severity of his cancer and how much time he had left. This could lead to something that appears to be a miraculous remission and a catastrophic relapse, but it may have been the natural progression of the disease.
- External factors may have had an effect:
My Wright, may have been taking other medications that were not disclosed, or he may have experienced other changes around the time of his supposed remissions and relapses. For example, changes in mental health, diet and other lifestyle changes could have had a potential impact upon the pattern of his disease.
What to take away from this
The case of Mr Wright is remarkable. It may also be inaccurate. But the best thing to take away from this is how much it captivated people. It made its way out of the medical journals into public life. People love the idea that they may have an innate ability to heal themselves. While this case may not be right, the people are not wrong. The placebo effect does exist and the more we learn about it, the more likely we are to be able to put it to use for our own benefit. Not necessarily to replace conventional treatments, but to work alongside them – to reduce side effects, to resolve symptoms and to improve outcomes for everyone.