Noe Valley Voice June 2007

Donald Abrams, Staying on Medicine's Cutting Edge

By Laura McHale Holland

Twenty-sixth Street resident Donald Abrams is leading an extraordinary life. At 56, he's not only at the peak of his career, but he's marching alongside alternative medicine guru Andrew Weil, to bring together the best of mainstream and alternative treatments for cancer.

First as a researcher with Nobel Prize-winning scientists Harold Varmus and Michael Bishop, and later as an oncologist at San Francisco General Hospital--and head of the hospital's HIV clinic--Abrams has spent half of his life on the front lines of physicians caring for AIDS and cancer patients. In 2003, after 20 years at SFGH, he was made chief of the hospital's Hematology-Oncology Division, a post he still holds today.

At a point in life when many people slow down, Abrams has done just the opposite. Last August, he took on a new job, as director of clinical programs at the 10-year-old Osher Center for Integrative Medicine at the University of California, San Francisco. The Osher Center teaches both doctors and patients how to mix alternative therapies with Western science--a synthesis Abrams has been championing for decades.

Abrams' pursuit of innovative treatments started back in the 1980s. "Before we had any treatments [like AZT], I became very interested in investigating alternative therapies for HIV. This disease was impacting my community, and it was rapidly fatal," Abrams says. "I felt we should leave no stone unturned."

He was a pioneer in the testing of cannabis. "In 1992, I became interested in looking at the possibility of marijuana being used medicinally for people with HIV, particularly for the wasting syndrome we were seeing. I have continued to study marijuana for the last 15 years, and it's been an interesting adventure."

Abrams' studies of marijuana piqued his interest in the healing powers of botanicals. And this led him to the 2002 Telluride Mushroom Festival in Colorado. There he met Weil, a well-known expert in complementary therapies, and learned about the integrative medicine program Weil was running at the University of Arizona.

Abrams decided to enroll in a two-year distance-learning program offered by Weil, while continuing to work in San Francisco. "I wanted to expose myself to more interventions to study, but the program ended up changing my life," he says. "It gave me a new appreciation for this new field, where what we do is take the best of conventional therapies and interweave them with modalities from complementary medicine to create, really, the best possible regimen for the individual, attending to their body, mind, and spirit."

After completing Weil's course in 2004, Abrams began holding an integrative oncology clinic one half-day per week at the Osher Center at UCSF. "It quickly became the highlight of my week," he says.

Two years later, as head of Osher's clinical programs, he is in charge of an expanding array of mostly gentle, non-invasive treatments and therapies. (He also remains chief of oncology at San Francisco General, but has given up stewardship of the HIV clinic to have more time for his new role at Osher.)

At Osher, he continues to see new patients, typically for 90-minute appointments. In addition to asking them about their medical history, he inquires about their eating and exercise habits, as well as their experience with complementary therapies. Then he makes recommendations tailored to their specific needs.

Some patients are beginning conventional treatment and are looking for ways to decrease the side effects of their cancer or its treatment, Abrams says. Others have completed their acute treatment and are hoping to prevent a recurrence. Still others may have "untreatable" cancer, and are looking for ways that the rest of their life can be symptom-free.

"I see patients who are hoping I'll be able to offer them some alternative to surgery, radiation, and chemotherapy, and I tell them that first and foremost I'm an oncologist, and I've been one for 25 years, and I'm really amazed at the progress we've made in being able to help cancer patients with our conventional therapies and I don't have any magic hidden at the Osher Center that could substitute for those interventions."

However, the therapies Osher does provide could have a big impact on their health and well-being, he says. Good nutrition is an important part of the prescription, but other options might be physical therapy, fitness training, massage therapy, acupuncture, herbs, biofeedback, meditation, guided imagery, integrative psychiatry, yoga, or tai chi.

"I believe people, especially those getting acute treatment, really benefit from having both their Western diagnosed needs cared for as well as their traditional Chinese medicine imbalances treated," Abrams says. "We've also just inaugurated a program called Live a Life You Love. Very often, people who have graduated from the practice of their oncologist feel a sense of abandonment and confusion and don't know what to do to get back on track with their life. We're hoping this will help people with reintegrating into society."

Abrams also is pleased that the Osher Center is starting to do clinical trials. "In addition to doing integrative oncology consultations with patients, we'd like to provide evidence to add to the growing knowledge about this new young field," Abrams says. Recent grant applications have focused on studying post-operative massage and the effectiveness of certain mushrooms.

When he's not seeing patients, teaching clinics, and investigating alternative therapies, Abrams is working on his latest collaboration: he is co-editing, with Weil, an Oxford University text on integrative oncology.

"We have about three quarters of the chapters already in, and I think it's going to be a great book when it comes out, hopefully toward the end of this year. I hope it builds momentum. There just aren't enough people doing this, and it's a shame because it's really exciting."

The book is part of a series targeted at health care professionals. "[It's] for practitioners caring for patients living with and beyond cancer. It is quite a comprehensive volume," he notes, explaining the spectrum of therapies he, Weil, and others are now folding into their practice.

So, what has Abrams learned from his patients and many years of research? He has discovered that the best way to live long and well is to keep trying new things.

"For me, being a 56-year-old man in academic medicine for the last 26 years of my life, a lot of my colleagues can become a little stuck and get disheartened with the work they do, but reinventing yourself and having sort of a midlife career shift is very exciting and challenging," he says.

It also helps to have a close personal relationship. In Abrams' case, that would be Clint Warner, his partner of 13 years. "I have the personal and intellectual support of Clint, who is a macrobiotic chef and very much in tune with healthy living and integrative medicine. That brings balance to my life--and great ideas."

The couple have recently added another "new thing" to their lives: a 13-week-old dachshund puppy.