Professor Baum's career was influenced by the death of his mother from breast cancer. He went on to conduct the first UK trials on Tamoxifen

"It's outrageous! The Prince's support of complementary medicine carries a lot of weight, but I think this is an abuse of his authority"

Breast cancer expert Professor Michael Baum has no time for massage,Reiki or homeopathy. In his view proven drugs are the only way forward - and he's prepared to argue the point with Prince Charles he tells David Cohen

Professor Michael Baum, the renowned breast cancer surgeon, smiles wryly when I ask him whether he thinks Prince Charles can be a force for good in medicine. "I'm already in enough trouble so let me pick my words carefully," he says. "It is symptomatic of a kind of post-modern madness when the Prince of Wales' medical opinion is regarded as being as valid as mine. It isn't. The man should stick to polo. "The people he wants to fund on the NHS - like homeopaths and reflexologists - belong to the Harry Potter School of Medicine. Their work is unproven and yet the NHS has just spent £20m refurbishing the Royal London Homeopathic Hospital at the same time as it is firing real doctors and saying it cannot afford to fund Herceptin, a proven life-saving drug. It's outrageous! The Prince's support of complementary medicine carries a lot of weight, but I think it is an abuse of authority."
He trembles with anger when I ask how he responds to being called a "closed-minded bigot" and a "heartless scientist" by the complementary medicine lobby, whose market is now worth an estimated £1.6 billion a year. "They are the closed-minded bigots," he says. "Every medical treatment needs to be rigorously tested before it can gain general acceptance, but that lot won't subject their treatments to deductive scientific tests." Baum, the Emeritus Professor of Surgery at University College, London - he lives in Hampstead Garden Suburb with his wife, Judy (they have three children and eight grandchildren), earns £100,000 a year and drives a new platinum Saab convertible - has been typically outspoken of late. On the very day that Prince Charles addressed the World Health Organisation to stress the benefits of complementary medicine. Professor Baum was the ringleader of a group of 13 senior doctors who wrote to every NHS Trust in the land to persuade them not to pay for such treatments. Professor Baum's trenchant views carry weight, not least because of his pioneering drug tests on Tamoxifen in the 80s that contributed to a 30 per cent decline in mortality (despite a near-doubling of breast cancer incidence) in the last 15 years. Now aged 69 and retired from the NHS, he maintains an office and a clientele at the private Portland Hospital in central London, which is where we meet for our interview. When I tell him that this week is apparently Homeopathic Awareness Week, he buries his nead in his hands and says, "You're kidding!"
He has no problem with people paying for things like reflexology, he assures me. "I just don't think it should be funded by the NHS. "Let me tell you my acupuncture story," he says, settling into his stride. "I was at a medical conference in Florence suffering terrible back pain and I happened to sit next to a woman who offered to give me acupuncture. Next day, I was miraculously entirely free of pain and spent two hours walking round the Uffizi Gallery in sublime comfort:' He pauses, a mischievous glint in his eye. "I used the word 'offered'. I never accepted the offer. I sometimes wonder how my perspective might have changed if I had!" Baum's run-in with the Prince of Wales goes back two decades, he says. "We met 20 years ago because after his infamous comment that 'medicine is too important to be left to the doctors', the British Medical Association set up some meetings between proponents of orthodox and complementary medicine. I was sent to represent the surgeons. I sat there listening to bizarre belief systems - like the core idea of reflexology that every organ in your body corresponds to an area on the sole of your foot, and the absurd homeopathic belief that water carries a memory - and I thought, the flat earth brigade would be more cogent. "But because Prince Charles was there, everybody was in awe of him and polite except for me!
It's outrageous! The Prince's support of complementary medicine carries a lot of weight, but I think this is an abuse of his authorityI spoke up agamst this politically correct 'received wisdom'. At the end of the conference, I was summoned over to meet the Prince. I said, 'Your Royal Highness, we may not agree on medicine, but I'm with you on the architects.' "Prince Charles looked at me and said, 'Funny you should say that Professor Baum. I was at dinner at the Royal Institute of British Architects last week, and they said, "We may not agree with you on architecture, but you're absolutely right about the doctors".' It was a witty reply and despite our disagreements, I've had a soft spot for the Prince ever since." Ironically Baum's scientific passion for challenging "received wisdom" comes from a profoundly personal place. The seminal event in his life, he reveals, was the death of his mother, Mary, from breast cancer. "It was a gruesome death spread over 18 months and watching it was devastating but the, worst part Baum pauses, repeatedly twisting an elastic band around his hand, as if the pain of his mother's death is still fresh, even though she died 37 years ago. "I adored my mother. She was dedicated to my father, Isidor, who struggled to make a living in the garment trade in London's East End, and to her five children, and I still feel guilty about what happened. Especially how we never told her she had breast cancer." The first sign that his mother, then 64, had developed breast cancer was when she started complaining of a sore back. "She went to see her doctor, and the diagnosis was devastating: these were secondary symptoms and my mother had advanced breast cancer. But in line with the 'received wisdom' in those days, the doctor said nothing of the diagnosis to my mother, telling only my father instead. "I felt it was my mother's right to know, but my father begged me not to tell her. Over the next 18 months, my mother underwent aggressive chemotherapy treatments, losing all her beautiful long black hair and suffering so badly. God knows what stories the doctors made up. But mum wasn't a fool. She must have known what she had, and she must have known that we knew she knew, but my father insisted nobody say anything and so we played out this ridiculous charade. From that time on, I developed a visceral hatred of 'received wisdom'."
Professor Baum, then 32, was a general surgeon but he hadn't specialised. Despite their modest beginnings as a Jewish family in Whitechapel, east London, and then growing up in Birmingham, his three brothers and sister would all pursue high-flying careers in medicine or science, but only he would specialise in breast cancer. "I don't want to over-glamorise my career by saying that I then went on a mission because of my mum, but the guilt that I hadn't done enough to help her did influence me. I also started questioning the treatment she'd received and it gradually dawned on me that everything we were taught in medical school was wrong. Nobody understood the disease. For 70 years, the unquestioned dogma was that breast cancer spread centrifugally from the breast to the lymphatic channels, and that the only treatment was radical mastectomy - removing the breast and underlying muscles and lymph glands - but it was a hopelessly failed strategy. The survival rate had not improved at all."
Tamoxifen, championed by Baum. has become a successful weapon against breast cancerBaum decided to investigate and, in the 70s, went to study under luminary Dr Bernard Fisher in Pittsburgh, America. "Fisher came up with an alternative paradigm, which was that although breast cancer might present as localised, it was systemic (had spread) and so radical mastectomy was like shutting the stable door after the horse had bolted." Radiotherapy coupled with drug therapy became the critical treatments, and in 1983, Baum conducted the first UK clinical trials on Tamoxifen, the drug that ultimately became the standard treatment for the 40,000 women who contract breast cancer every year in the UK. When, 12 years ago, Baum's sister Linda got breast cancer, she would benefit directly from her brother's contribution to medical science. How does he feel about that? He glows. "My sister is a senior speech therapist and when she got it, she was just 48 years old. She is married [with children) and had a whole life to look forward to and so when she told me she had breast cancer, it was a huge shock, but I made sure to direct her to a doctor I could trust. I take huge pride in the fact that because of our groundbreaking work, my sister did not suffer the awful fate of my mother and - due to a combination of surgery, radiotherapy and Tamoxifen - she survived."
Recently, drug treatment has taken another dramatic leap forward with the invention of Herceptin, and more targeted and less toxic drugs, called aromatase inhibitors, which work by inhibiting an enzyme that metabolises oestrogen in post-menopausal women. "We need the NHS to put money into these brilliant new drugs, not flaky treatments advocated by Prince Charles on his latest flight of fancy." But Baum's controversial public battle with alternative medicine has run concurrent with a much darker private one. In 1984, just as his medical career was taking off, he became "acutely depressed", he says, a combination of overwork and under-pay. "I burned out. I felt of no value to anybody. I felt my life was meaningless, all vanity. The only reason I didn't contemplate topping myself was because of the love of my wife and children." Did he contemplate psychotherapy? "No, I took hard drugs for six months, which were vile, and I did some behavioural therapy and I was off work for six weeks. In my case, I have a vulnerability to depression, but it is stress related." He had an "echo" in 1995 when he again overloaded himself and started getting panic attacks. "It's about not respecting the self enough," he says. "I have since seen many of my colleagues collapse with similar depressions. Doctors are not looked after on the NHS. We"I take huge pride in the fact that because of our groundbreaking work, my sister did not suffer the awful fate of my mother" don't care enough for the carers." Perhaps, I suggest, what he needs is a couple sessions of deeply relaxing crystal therapy. "Bogus! Charlatans!" he splutters. "You know, in the old days, people knew the value of doctors. Take my father. He died of a heart attack aged 79 in a car accident. Just before he died, he got out of his car to angrily challenge the other driver. Our father's last words before he collapsed on the road were, 'I have sons!' He was so proud of us. He saw how hard we worked.
"Today, there are some homeopaths who qualify after a weekend course and then tell their client to take some tiny pills that have as much medicinal use as piss. But as I said, I don't want to say anything too controversial, I'm in enough trouble as it is."

[CANDIS March 2007]

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