Why am I in Germany receiving immunotherapy treatments? Why do many health care experts say Germany and surrounding countries offer the most innovative cancer therapies in the world? I’ve wondered about the source of this innovation around cancer care since I started doing research into European cancer clinics, and I’m just now starting to piece together some answers.

In Germany, there is a long tradition dating back to the 1800s of legally recognized specialties in medicine such as homeopathy and anthropological medicine being part of mainstream health care. The German medical system offers patients a range of therapeutic modalities as a part of standard care, including many modalities that are considered unconventional in the United States. Germans do not possess the same skepticism that exists in the United States about what many Americans label alternative therapies.

The public attitude in German about health care is also reflected in German law that allows the individual practice of medicine. Today’s German constitution refers to the individual as an independent entity. German law supports this independence by providing doctors with special freedoms of therapy as long as the treatments are in the best interest of the patient. Switzerland has some similar laws.

In mainstream medicine, individual therapy is generally not practiced in the United States for many reasons, some of which include how pharmaceutical companies approach cancer drug development, the traditionally accepted clinical trials paradigm, and how the Food and Drug Administration approves new therapies. Some cancer clinics in Europe offer therapies are customized to each patient. Since individuals are unique, why not create a treatment plan specific to their internal strengths and weaknesses?

As I’ve met Germans since my arrival over three weeks ago, I have shared why I’ll be living in Cologne for six months. “What, you came here for cancer treatments? Our perception is that the United States has the best of everything,” has been the response. I wish that were the truth. I wish the U.S. health care system offered a person-centered system of medicine. I wish the U.S. offered some of the treatments available abroad to those not willing or able to travel for medical care.

Current U.S. statistics indicate that one in two men and one in three women will be diagnosed with cancer in their lifetime. With incidence rates increasing and survival rates generally not improving, we need better cancer therapies available to everyone. We need to do more now. Cancer care in the United States is in dire need of novel approaches. Those in the cancer care development and delivery system need to think and work outside the current paradigm. The value of human life is too high. People are dying. People have died. Some survivors, including family members and other loved ones, lead shattered lives in the aftermath of loss.

“Do no harm,” said Hippocrates, the founder of medicine, in the 4th Century B.C. How can modern cancer care provide more effective therapies and do less harm in the process? That is the billion-dollar question. And yet, some of the answers might already exist. Perhaps the largest barrier is the willingness to think outside the box.

On June 20th, 11 million dendritic cells cultured in a laboratory over 7 days from my monocytes were given to my amazing 5 feet by 10 inch frame. Looking at my dendritic cells in a tiny tube, I felt awe for the sophistication of the treatment. Sixty percent of the dendritic cells were administered intravenously, and fourty percent subcutaneously into each side of my upper arm below my shoulder. The dendritic cell vaccine contained interferon alpha and gamma to help create an immune response. The injections caused some minor and temporary discomfort, but no significant pain.

Tiredness has overcome me the last several days around mid-afternoon. Since I’m in Cologne to heal, the needs of my body are paramount, so when I’m tired, I sleep. This afternoon, with exhaustion lingering in the immediate horizon, I knew I had to act quickly. Instead of sleeping, I wanted to actualize my plan of going for a bicycle ride along the Rhine. I haven’t been exercising enough since arriving in Cologne, and because physical activity is also medicine for my body and soul, I decided to try biking over sleep. Knowing I could always just return home for a nap if I felt too tired once on the road, I filled my water bottles, packed my bag, and headed outside.

As I approached the Rhine, I noticed a layer of depression in my tiredness. Depression is a tricky label though. I knew I felt lonely. I hadn’t made any social plans for the weekend so I could spend time by myself, which seems to inevitably lead me to some degree of loneliness. And yet, since my healing encompasses coming more fully into myself and my wholeness, I feel a strong need to explore the loneliness, befriend it, and hopefully integrate what lies inside of that surface angst.

My thoughts, via my mind, weren’t providing any comfort. I began feeling more and more alone. My vision became slightly fogged as my eyes began to water. And then, as if right on cue, I heard Irish music. I maneuvered my way across the street a half block later and rode onto a dirt path.

I entered an enchanted forest. Sounds from various directions bounced off the lush green trees, bushes, gray rock walls, people, and the sky. After locking my bike to a tree, I wandered toward the tunes. Peering down into a forest alcove lined with ancient stones, I observed and listened to the creation of a jazzy trumpet melody. Exploring further, I walked through a grassy field and watched a band of accordion players jamming together in song. Back into the dense forest, I strolled past wooden booths selling cotton candy, watermelon, and freshly cooked paella sizzling in a 4 feet by 4 feet circular metal pan. I admired a stage surrounded by a wooden ship filled with children telling some type of story in their distinctive German tongues. With a clear hint of joy emerging inside of me, I then heard full-blown, ecstatic, electric Irish music.

Stone steps created the path toward the stage framed by a tree trunk and its surrounding 30 feet braches with golden green leaves reaching out toward the afternoon sun. Three men each played violins for an audience of over 400 eyes, some staring at the musicians with enchantment, and others closed yet moving to an internal rhythm. Absorbing their tunes, I felt my cells shift and almost explode in every direction. Energy moved through my legs, and my feet chakras blossomed like tightly held buds opening to display their beauty. The violin group played three more songs, and I experienced more and more delight.

Feeling content, I left the enchanted forest and continued south along the Rhine, but only to begin feeling blue again. “Why do the emotions shift so dramatically?” I wondered. I sat with my melancholy and then released it to the universe as I biked past little towns, harbors for small boat, as well as bars directly off the Rhine’s path.

Miles later, for reasons I cannot precisely define, I realized I no longer felt alone. Everyone was with me, including my nephew, niece, brother, sister-in-law, parents, grandparents, friends, along with each person that has ever expressed love in my direction. My interconnectedness sustained itself, and I felt my attachment to containing that mindset in my being. I then wished it upon myself. I wished for interconnectedness, wholeness, inner peace, acceptance, and love. I wished these things for all people. Reversing my course north in the direction of Cologne, I peered at the glimmering surface of the Rhine, and wished away into the early evening light.

Arriving at the Medical Center of Cologne (MCC), I met with Robert Gorter, MD, PhD, to discuss my treatment plan in more detail. My June 12th appointment wasn’t my first time at MCC. I spent a few days in Cologne this past January to interview Dr. Gorter about his protocol and perform a site visit of his clinic.

Dr. Gorter outlined my treatment plan. During month one, I will receive localized hyperthermia to the head along with infusions on Tuesdays and Fridays. My dendritic cell vaccine will be administered with interferon alpha and interferon gamma once monthly. In addition, I’ll begin the Newcastle disease virus during month two. And, a few other therapies will be added according to the results of my immune status testing.

Dr. Gorter had just returned from the American Society of Clinical Oncology’s annual meeting, and he noted a paradigm shift within conventional oncology in relation to immunotherapy treatments over the last five years. He said the attitude is no longer if, but who, how, and what. His report made me feel like we are on the cutting-edge.

Reporting to the clinic on Tuesday morning, I had several vials of blood drawn for the dendritic cell vaccine and immune status testing. A clinic physician from Mexico, Eloy Pulido, MD, performed the blood draw and programmed the hyperthermia device. He speaks English, and we spoke some Spanish, too.

After the blood draw, my first treatment with localized hyperthermia and infusions began as I rested on a bed of salt water that creates an electromagnetic field. The hyperthermia device, compromised of water and electromagnetic substances, was pressed directly over the left side of my head. The device became hot within a few minutes of its application. During the first week, the temperature index is adjusted to between 70 and 80 percent of full capacity to allow an acclimation process.

During the treatment, my head warmed, followed by increased heat throughout my entire body, a subsequent sweat, and also a slight elevation in my heart rate. Dr. Pulido said all of my reactions were normal, and therefore I wasn’t alarmed and even meditated during parts of the procedure. I was dizzy for less than two minutes after the procedure, but Dr. Pulido again said that was common. Leaving the clinic, I was slightly fatigued and nauseous.

A German nurse administered my second hyperthermia treatment on Friday. She doesn’t speak English. Feeling the heat once again, I appreciate the added benefit of sweating away toxins during hyperthermia. New observations included a funky taste in my mouth at the treatment’s end, which Dr. Pulido said was associated with the infusions. The more interesting observation for me was that the glands in my neck became swollen about 25 minutes into the treatment and my nose stuffed up. My theory is that the hyperthermia stimulated an immune response in my system, and my swollen glands and stuffy noise were evidence of that. When I told Dr. Pulido, he explained the literature does not cite such a side effect from hyperthermia, and that no other patient had reported a similar reaction. Since I have the good fortune of being highly sensitive, I assured him I might report effects from the treatments that he had not previously heard.

My first week of treatments also included a baseline MRI scan. My last MRI was in early January, so I was due for one anyway. I’ve been fairly nervous for the ritual MRI scans over the last eight years. This time around, I wasn’t. My new environment in Germany, combined with the fact that I am receiving more aggressive treatments for the tumor, provided both a distraction and degree of peace in relation to my scan.

I met with the radiologist, which I had never actually done before a scan. Feeling tremendous intrigue about the German medical system, I inquired with the radiologist if he usually met with patients before their scans. He explained that for some scans he doesn’t meet with patients, but for more complicated ailments, he prefers to collect information so he can know what to look for. Sharing my appreciation for their system, the radiologist emphasized that information can become lost in between practitioners, and when everyone communicates together, there is more potential for clarity and accuracy. For those of you who know the story of my recurrence, I know this all too well.

Examining the images with the radiologist and Dr. Gorter five minutes after finishing the MRI, we all noted the tumor in my left temporal lobe whose measurements appeared comparable to my last few scans. In addition, the radiologist pointed to a line on the film through part of the tumor. He explained that my tumor wrapped around a large artery and emphasized the artery would make a complete surgical resection virtually impossible, and the procedure itself more dangerous and risky. Interestingly, none of my doctors had mentioned the artery to me before, although I had certainly seen the line next to my tumor on my previous MRI scans. Most importantly, we have a baseline from which to track the results of the immunotherapy treatments. I’ll have my next scan in five months.

“Turn off your cell phones. The cabin doors are closed. Everyone must turn off their cell phones,” announced a flight attendant. “We are about to depart.”

Picking up my cell phone from the empty seat next to me, I pressed the off button. I smiled looking out the window. Closing my eyes, I could feel the quiet. Every ounce of my being assured me that I was meant to be a solo traveler. A voice inside of me calmly stated, “Your healing demands a depth of internal presence that can only be achieved alone.”

I have been meandering for almost a decade, sometimes with and in other moments without direction, toward a destination that I couldn’t exactly define. Many guideposts, including signs, signals, voices, and people, have shown me the way.

And I must now find guidance within myself. That doesn’t mean I will not have the occasional consultant. However, my healing must come from the inside out. For me, there is no other way.