media and images published by Weekend West, published 16 June 2018
Australian cricket coach Justin Langer calls him “the Saint”. His patients refer to him as a hero. But to many of his medical colleagues in WA, haematologist Dr David Joske remains an unsettling enigma.
He is, after all, the man who 16 years ago invited a coterie of “quackery” into their evidence-based world. David’s initiative to provide free complimentary therapies to cancer patients in hospital – a project that came to be known as Solaris Cancer Care – met with ripples of concern among the medical fraternity at the time. Whispers in the corridors. Sternly worded letters from surgical colleagues. Even a nomination from the Australia Skeptics’ Association for the Most Preposterous Piece of Pseudo-Scientific Piffle, in 2003.
For quietly spoken David – by his own admission a “risk-averse, mainstream sort of person”, instigator of the bone marrow transplant unit at Sir Charles Gairdner Hospital – the pushback stung. A couple of years into the project, he experienced a “crisis of confidence” and almost walked away.
That’s when his moral compass kicked in. ‘As my father (also a doctor) would say, decisions are easy, consequences are hard,” David says. “If you know the right decision to make, you make it. I said to myself ‘I’m going to continue to do what I think is right here and whoever chooses to follow me, well, that is up to them’.”
Hence Justin Langer’s moniker for the doctor he’s come to call a close friend. “I call him the Saint because what he does is incredibly brave,” says Justin, who’s become an official patron of Solaris.
Justin’s mother used the centre before she succumbed to cancer last year. “To have the courage and wisdom to see there’s so much more to (treating cancer) than modern medicine – that’s amazing. I’ve always believed in the mind-body connection but that’s me as a sportsman. He’s a doctor and his position takes bravery.”
David’s conviction, back then and still today is based on two observations; firstly that the patients who avail themselves of holistic healing, relaxation therapies and counselling tend to respond better to conventional cancer treatments such as chemotherapy and radiation, and secondly, that many patients are doing all the stuff anyway.
“About 70per cent of cancer patients are already doing these things to simply get through their treatment – massage, acupuncture, whatever gives them some comfort – and they’re usually not telling their doctors about it because they expect a certain reaction,” she says. “So my idea was why not acknowledge this type of healing? Bring it into a patients medical team, provide it free of charge in a supervised setting and, while we’re at it, let’s see if there’s anything to it all. This is not about curing cancer; I’s about making the journey easier for people It’s about getting people to the best space they can get to given the hand of cards they’ve been dealt.”
From the day he opened the doors of Solaris Cancer Care with Sir Charles Gairdner Hospital in 2001, David has witnessed a steady, at times, relentless, demand for the centre’s services. There are now five centres across WA, three based in hospitals, and it’s become the model for similar centres on the east coast. A network of approved complementary therapists delivers up to 700 free treatments to WA cancer patients each month, among them massage, reflexology and reiki. There’s also a professional counselling service on hand for those grappling with the fear and anxiety wrought by cancer diagnosis.
“It’s been 100 miles an hour since the minute we opened the doors,” David says. “About a year into it, I became concerned that I’d started something with such a large demand. So I set about creating a governance model and established a steering committee that reported to the hospital. Anther key step was to set up a research committee where we committed ourselves to measuring what we were doing.” David and his team have now contributed to multiple research papers in peer-reviewed medical journals to document the effectiveness of Solaris.
In 2014, a study published in the US-bases Journal of Holistic Nursing found the centre “appeared to enable coping with the diagnosis and treatment of cancer by facilitating comfort and increasing perceptions of personal control”.
A separate journal study in they same year interviewed 66 Solaris patients and found 100 per cent of them would recommend complimentary therapies to other patients, citing empowerment, support and relaxation as the primary benefits. But research, while important, is sometime beside the point, according to Dr Simon Towler, former head of WA’s Department of Health, intensive care surgeon and cancer survivor. Simon was a supporter of Davis’s work long before circumstance made him a true believer.
“I was never one of the ones laughing,” Simon says. “It was already clear to me that some of the things that made the people feel better were not evidence based. Patient orientation, the will to live, the level of engagement with their doctors… the indescribable parts of what gets people well again is not something we’ve largely researched.
“Personally, I’d always felt that complementary therapies had value because I think patient autonomy is something we should respect. If you don’t support the patient to be as well as they can be, then the whole cancer outcome is influenced. This is where traditional medicine and complementary therapies start to overlap. My sense had always been that there is something more to this story.”
But while the cancer community and some parts of the medical fraternity were “starting to have different conversations about the cancer journey”, back in the late 1990s, Simon says David was the man to take things to the next level in WA.
“He has a personal presence and a very high-quality reputation as a clinician, so for someone like him working in an evidence-based environment to say there is something else here of value that is persuasive,” he says.
“Davis championed this in the face of a lot of early resistance. It would have been easy for him to give up but he won (the critics) over. And in all the years it’s been operating, I’ve never heard a patient complain about Solaris.”
Of course, Simon might never have imagines, as few of us do, that he’d one day become the cancer patient of which he often talks; blindsided by the fear, paralysed by uncertainty and staring down the tunnel of a taxing treatment regime.
“As soon as the diagnosis came through in 2012 (cancer in his neck cause by the HPV virus), my doctor said you’re stopping work – you’re in the fight of your life,” Simon recalls. “I was overwhelmed. I had four cycles of chemo and then radio. By the end of the chemo, I couldn’t feel mt fingers and toes; I couldn’t taste any food. Everything is hard about cancer treatment. Your world is built around appointments and discomfort.”
Two things made Simon’s cancer journey easier; referral to a Chinese medical practitioner (who he continues to see) and regular visits to the Solaris centre within St John of God Subiaco. “The first time I went there, I just sat there for a few hours,” he says “I was slightly curious to see what it was all about. So I sat and watched what went on, the sort of people going in and out and what they were there for I wanted a sense of how people felt in the centre. And what I discovered was a hugely positive environment. It quickly become a familiar place for me, a comfortable place, a place to get information, to get a treatment. And being with a hospital setting is very significant. Hospitals can be very busy, impersonal places. When you’re a cancer patient wearing a wig or just feeling awful, you don’t want to be sitting in a cafeteria between appointments. The Solaris setting of care and support dramatically augments what hospital has to offer.”
While Simon mostly booked in massages when as Solaris –“I find it very restful and it really helped during my treatment” – he also pushed himself out of his comfort zone by trying such things as reiki therapy. “It was a bit odd. I’d never done it before. Indeed, I never would have dreamt of doing it before getting cancer.”
In fact, it’s treatments such as reiki that most worry skeptical observers of Solaris A touch-based therapy targeting “life force energies” with the body, it’s a bridge too far for many conventional doctors. But David Joske is reticent to get rid of it while patients continue to report its benefits.
Indeed, on one of the days when I am at the Solaris centre within Sir Charles Gairdner working on this story, a new-found reiki convert in the shape of Surfing WA chief executive Mark Lane walks through the door. The 54-year-old father-of-three looks exhausted; wiped out by cancer treatments far more brutal than any big wave. But he recently discovered reiki through Solaris and says it’s the only thing that has given him any comfort.
“I can’t explain it,” Mark says. “I’ve no idea how it works, but it does. After the first time I had it, I instantly felt quite good, as opposed to terrible. By the next day, I felt great, actually great, and that lasted for another half day, so I had these two days out of my treatment where I didn’t feel absolutely awful. And the next time I had reiki, the same thing happened. So here I am again. It helps me that much.”
Simon Towler says this is another benefit of Solaris: the capacity to keep cancer patients pushing through treatment regime they might otherwise give up on. “There is a lot of evidence in the past two decades to show that if you start a treatment and don’t finish it, you’re worse off than not starting it at all.” He explains. “Getting through the treatment is really tricky. When you’re feeling sick, when you can’t taste food, when you’re vomiting … keeping going is hard work. If you don’t have support system around you you’re likely to give up and then you’re worse off. What I found is that Solaris really helps you deal with all those feelings of ‘This is bloody hard’. Even if you just use it as a drop-in centre, a safe place, a place to wait, to talk with other going through similar experiences, even if you don’t use the therapies, it is still hugely beneficial. It can change your commitment to treatment. And that’s not something you can measure. The evidence base will never be conclusive. There’s a very big part of health care that doesn’t look like all the other stuff.”
Although she’s never met him in person, schoolteacher Wending Porch, 52, has no hesitation in characterizing Solaris founder David. “He’s my hero, plain and simple,” the Scarborough mother-of-two says. “That he had the foresight to create something like Solaris; to do something so groundbreaking in this field … he’s just an incredible person.”
Wendy is adamant her cancer journey, which started four years ago with a diagnosis so dire that her oncologist’s advice was to “go on a family holiday, take lots of photos and get your will in order”, would have been an entirely different experience without Solaris.
Across 12 increasingly taxing rounds of chemotherapy, she immersed herself in the centre’s supportive offerings, signing up for everything from basic massage and yoga through no less mainstream practices such as Feldenkrais (an exercise-based therapy that proposes to reorganize connections between the brain and body). Her weekly visits to Solaris, often just to sit in a comporting place that felt nothing like the rest of the hospital, still her mind against cancer’s rogue waves of mortal terror.
“When I was first diagnosed, I fell to pieces,” Wendy recalls. “My daughter Marley was 13, my son Sam was eight, and your mind goes straight to the dark place. I thought they’re too young not to have a mother. It’s a terrifying position to be in.”
Wending resolved to put her trust in her doctors but also to do everything she could do for her own wellbeing. When a breast cancer nurse told her about Solaris, she decided to check it out. “And I was immediately blown away by the feel of the place – the kindness of the people there, the amount of information on hand, the access to free therapies … it’s like a sanctuary within a hospital,” she says.
“Every time I had a chemo treatment or another appointment, I would book myself in for something at Solaris. It meant I actually looked forward to my cancer treatment instead of it being all doom and gloom. Because those doctors’ appointments … they were never good news. And how do you cope with that information every time you go in? Solaris helped stop all the negative feedback loops running through my brain. And you need that calmness, that occasional sense of peace and connection, to get through cancer treatment – because it is so, so hard.”
Wendy took a year off work to pour herself into beating her disease, meaning the cost of having massages and alternative therapies was largely out of the question. But the fact Solaris’s treatments are free is not just about economics. “To have these people – and they are generally really good, talented therapists – give their time to me in my darkest hours for no payment … it just restored my faith in humankind,” she says.
“There is something very special about the fact that they ant t be there helping you, they’re on your side in this lonely journey”
Wendy is now four years’ cancer free.
Chadia Scheel, 60, knows she would not be alive if not for conventional medicine. Nine rounds of chemotherapy, major surgery and multiple clinical trials over 12 years have kept her chronic lymphatic leukemia at bay.
But she also believes this: medicine can heal your body; it cannot heal your soul.
And it’s this part of the healing puzzle – the part many Western doctors have only begun to speak about in recent decades – that Chadia knew she would have to address in her own way. That is, until she met David.
“I needed a doctor who was open to other ways of healing because I wanted to be supported in what I was doing and what I wanted to be able to share information and ideas without being ridiculed,” Chadia says. “I was referred to David by my GP and when I saw what he had created in Solaris, I knew he was my guy.”
At the start of Chadia’s cancer journey, Solaris was a centre in its infancy – a room with two small spaces with Sir Charles Gairdner Hospital. She has watched it blossom around her and also felt a sense of its growing acceptance with the medical fraternity.
“I see so many more people using it now when I am there, and so many more therapists too,” she says.
“You get the feeling it has earned approval. The shift by doctors to embrace complementary medicine has been slow, and I wish it had been faster, but at least it seems to be happening.”
Chadia recently became a grandmother, a pleasure she thought might never be hers when she was told four years ago that she had just three months to live. A clinical trial saved her at that terrifying juncture- though she has no idea at the time whether she was being given the cancer-killing drug on trial or the placebo – but the worry surrounding that death sentence has never left her.
Solaris, she says, operated at the epicenter of cancer’s bedfellow; fear.
“There’s so much fear. The fear of dying, the fear of suffering, the fear for your family for your finances. What Solaris provided – that touch, that connection – it soothes your soul. It’s a life anchor.
“Too many people do just what their doctor tells them and nothing more. They don’t look at nutrition, mindfulness, alternative therapies. You have to put it all together and Solaris allows that.”
Solaris Cancer Care is itself now fighting for survival.
Original funding for the centre has long ago expired and there is no government money in the pipeline. It’s only through fundraising – and the generosity of therapists and volunteers – that Solaris continues to deliver more than $1 million worth of health care, counselling and support each year to the State’s cancer patients.
But demand is rapidly outstripping the capacity to service it. The centre experienced at 14 percent increase in patient numbers last year and is on track for a 20 per cent leap in 2018. With more than 12,000 people in WA diagnosed with cancer each year, there is little chance of these numbers easing.
On the back of a $200,000 shortfall in fundraising earlier this year, Solaris launched the May we Survive and Thrive campaign last month to urgently appeal for community and philanthropic donations.
“We have helped out many patients and their families get through difficult times,” David says.
“We are now hoping the local community can help us in return with a donation that enables us to continue and widen our range of services.”
In true opening-batsman style Justin Langer goes much harder; “Look, this is a no-brainer for me. It’s a brilliant cause. These are kind, caring, big-hearted people doing something extraordinary. I’ve seen it firsthand – it doesn’t get much closer than your mum. There are so many good causes out there, for sure. Great charities. It’s a competitive market. But cancer doesn’t discriminate – it can touch anyone and it does. Solaris provided compassion, empathy and kindness to people going through the worst. Now they need some help in return.”