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"Alternative" Cancer Treatments


Questionable Cancer Therapies


Stephen Barrett, M.D.

Victor Herbert, M.D., J.D.

The American Cancer Society (ACS) has defined questionable methods as
lifestyle practices, clinical tests, or therapeutic modalities that are
promoted for general use for the prevention, diagnosis, or treatment of
cancer and which are, on the basis of careful review by scientists and/or
clinicians, deemed to have no real evidence of value [1]. Under the rules of
science (and federal law), proponents who make health claims bear the burden
of proof. It is their responsibility to conduct suitable studies and report
them in sufficient detail to permit evaluation and confirmation by others.
The ACS evaluates cancer methods by asking three questions:

* Has the method been objectively demonstrated in the peer-reviewed
scientific literature to be effective?
* Has the method shown potential for benefit that clearly exceeds the
potential for harm?
* Have objective studies been correctly conducted under appropriate
peer review to answer these questions?

FDA Historian Wallace F. Janssen has noted that in every decade since 1940,
a questionable cancer remedy has attracted a large following and become a
national issue [2]. It was Koch Antitoxins in the 1940s, Hoxsey treatment in
the 1950s, Krebiozen
<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/krebiozen.html>
in the 1960s [3], laetrile
<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/laetrile.html> in
the 1970s, and immuno-augmentative
<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/iat.html> therapy
in the 1980s. Today's questionable methods include corrosive agents, plant
products, special diets and "dietary supplements," drugs, correction of
"imbalances," biologic methods, devices, miscellaneous concoctions,
psychological approaches, and worthless diagnostic tests. Many promoters
combine methods to make themselves more marketable. A 1987 ACS investigation
found that 452 (9%) of 5,047 cancer patients identified through a telephone
survey had used questionable treatments. Of these, 49% had used "mind
therapies" (mental imagery, hypnosis, or psychic therapy) and 38% had used
diets [4]. The dangers of using questionable treatments include delay in
getting appropriate treatment, decreased quality of life, direct physical
harm, interference with proven treatment, waste of valuable time, financial
harm, and psychological damage [5].

Quackwatch has heard from several people who have been defrauded of large
sums of money pursuing nonexistent cancer "cures." Most of these cases
involved offshore clinics to whom money was wired in advance. The Federal
Bureau of Investigation (FBI) has jurisdiction over cases involving wire
fraud. Americans who believe they have been victims of wire fraud should
report what happened to the FBI.

Typical Misrepresentations

Proponents of questionable methods typically claim that marketplace demand
and testimonials from satisfied customers are proof that their remedies
work. However, proponents almost never keep score or reveal what percentage
of their cases end in failure. Cancer cures attributed to questionable
methods usually fall into one or more of five categories:

1. The patient never had cancer.
2. A cancer was cured or put into remission by proven therapy, but
questionable therapy was also used and erroneously credited for the
beneficial result
3. The
<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/miracles.html>
cancer is progressing but is erroneously represented as slowed or cured.
4. The patient has died as a result of the cancer (or is lost to
follow-up) but is represented as cured.
5. The patient had a spontaneous remission (very rare) or slow-growing
cancer that is publicized as a cure.

Promoters of questionable methods often misrepresent their methods as
"alternatives." Genuine alternatives are comparable methods that have met
the criteria for safety and effectiveness. Experimental alternatives are
unproven but have a plausible rationale and are undergoing responsible
investigation. Questionable "alternatives" are unproven and lack a
scientifically plausible rationale. When referring to the latter, we use
quotation marks because they are not true alternatives. Some promoters of
"alternative" methods are physicians or other highly educated scientists who
have strayed from scientific thought. The factors that motivate them can
include delusional thinking, misinterpretation of personal experience,
financial considerations, and pleasure derived from notoriety and/or patient
adulation.

Misinformation about questionable cancer therapies is spread through books,
articles, audiotapes, videotapes, talk shows, news reports, lectures, health
expositions, "alternative" practitioners, information and referral services,
and word of mouth. Promoters typically explain their approach in commonsense
terms and appear to offer patients an active role in their care: (a) cancer
is a symptom, not a disease; (b) symptoms are caused by diet, stress, or
environment; (c) proper fitness, nutrition, and mental attitude allow
biologic and mental defense against cancer; and (d) conventional therapy
weakens the body's reserves, treats the symptoms rather than the disease
[6]. Questionable therapies are portrayed as natural and nontoxic, while
standard (responsible) therapies are portrayed as highly dangerous. The
figure below comes from a misleading comic book designed to undermine public
trust in conventional methods.



During the past few years, the news media have publicized "alternative"
methods in ways that are causing great public confusion. Most of these
reports have contained no critical evaluation and have featured the views of
proponents and their satisfied clients. Many have exaggerated the
significance of the National Institutes of Health (NIH)'s Office of
Alternative Medicine (OAM) -- now called the Center for Research in
Alternative and Complementary Medicine -- whose creation was spearheaded by
promoters of questionable cancer therapies who wanted more attention paid to
their methods. Most of the its advisory panel members have been promoters of
"alternative" therapies. In 1994, the OAM's first director resigned,
charging that political interference had hampered his ability to carry out
OAM's mission in a scientific manner [7]. The OAM has funded several dozen
studies related to "alternative" methods, including a few related to cancer
treatment. However, it remains to be seen whether such research will yield
useful results. Even if it does, the benefit is unlikely to outweigh the
publicity bonanza given to questionable methods. Some of today's
"alternative" methods are described below in alphabetical order. Longer
reports on many of the methods can be accessed by following the hyperlinks.

Antineoplastons

Stanislaw R. Burzynski, M.D., has given the name "antineoplastons" to
substances he claims can "normalize" cancer cells that are constantly being
produced within the body. He has published many papers stating that
antineoplastons extracted from urine or synthesized in his laboratory have
proven effective against cancer in laboratory experiments. He also claims to
have helped many people with cancer get well. A 1992 analysis concluded that
none of Burzynski's "antineoplastons" has been proven to normalize tumor
cells [8].

In 1988, Burzynski got a tremendous boost when talk-show hostess Sally Jesse
Raphael featured four "miracles," patients of Burzynski, who she said were
cancer-free. The patients stated that Burzynski had cured them when
conventional methods had failed. In 1992, "Inside Edition" reported that two
of the four patients had died and a third was having a recurrence of her
cancer. (The fourth patient had bladder cancer, which has a good prognosis.)
The widow of one of Raphael's guests stated that her husband and five others
from the same city had sought treatment after learning about Burzynski from
a television broadcast -- and that all had died of their disease. In 1995, a
federal grand jury indicted Burzynski for mail fraud and marketing an
unapproved drug. The indictment charged that he had billed insurance
companies using procedure codes for chemotherapy, even though his treatment
was not chemotherapy. He was tried in 1997 but not convicted.

In 1998, the Texas Attorney General secured a consent agreement stating that
Burzynski: (a) cannot distribute unapproved drugs in Texas; (b) can
distribute "antineoplastons" only to patients enrolled in FDA approved
clinical trials, unless the FDA approves his drugs for sale; (c) cannot
advertise "antineoplastons" for the treatment of cancer; and (d) on his
website and in promotional material and ads must place a disclaimer that the
safety and effectiveness of "antineoplastons" have not been established. The
agreement also called for Burzynski to pay $50,000 to reimburse the Attorney
General's office and the Texas Health Department for the cost of their
investigation [9]. The
<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/burzynski2.html>
Cancer Letter subsequently noted that although Burzynski has set up many
"clinical trials," they do not conform to usual standards [10].

CanCell

CanCell -- originally called Entelev and recently renamed Cantron and
Protocel -- is a liquid claimed to cure cancer by "lowering the voltage of
the cell structure by about 20%," causing cancer cells to "digest" and be
replaced with normal cells. Accompanying directions have warned that bottles
of CanCell should not be allowed to touch each other or be placed near any
electrical appliance or outlet. CanCell has also been promoted for the
treatment of AIDS, amyotrophic lateral sclerosis, multiple sclerosis,
Alzheimer's disease, "extreme cases of emphysema and diabetes," and several
other diseases. In 1989, the FDA reported that CanCell contained inositol,
nitric acid, sodium sulfite, potassium hydroxide, sulfuric acid, and
catechol. Subsequently, its promoters claimed to be modifying the
formulation to make it more effective [11]. They have also claimed that
CanCell can't be analyzed because it varies with atmospheric vibrations and
keeps changing its energy [12]. Laboratory tests conducted between 1978 and
1991 by the NCI found no evidence that CanCell was effective against cancer.
The FDA has obtained an injunction forbidding its distribution to patients.


Cell Specific Cancer Therapy


According to information that was on the promoter's web site during 1997,
Cell Specific Cancer Therapy (CSCT) is applied with a device that is four
inches thick, shaped like a donut, and exposes the patient to a magnetic
field that is much weaker than that of magnetic resonance imaging. It is
available at a clinic in the Dominican Republic. The advertised fee is
$20,000, payable in advance, but the fee may be reduced or waived for people
unable to pay. CSCT is claimed not to cure cancer but to "destroy active
cancerous cells in a body and to do so without causing any damage to healthy
cells." Its objective is to destroy enough cancerous cells that the body's
immune system is "once again able to take over and do its normal job." The
device is claimed to "detect cancerous cells with a sensitivity much greater
than that of either conventional magnetic resonance imaging (MRI) or CAT
scans" and to destroy cancer cells without harming adjacent normal cells."
The promoter claims that cancerous cells have an "atypical metabolic
mechanism that makes them "susceptible to polarizing electromagnetic
fields." There is no scientific evidence that magnetic energy can
selectively destroy cancer cells. Similar treatment is offered at the
Davidson
<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/davidson.html>
Cancer Clinic in Mexico, whose proprietor is facing criminal charges for
fraud.

<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/clark.html>
Clark's "Cure for All Cancers"

Hulda Clark, Ph.D., N.D., claims that (a) all cancers and many other
diseases are caused by "parasites, toxins, and pollutants"; (b) cancers can
be detected with a blood test for ortho-phospho-tyrosine and a device that
identifies diseased organs and toxic substances; (c) cancers can be cured by
killing the parasites and ridding the body of environmental chemicals; (d)
black walnut hulls, wormwood, and common cloves can rid the body of over 100
types of parasites; and (e) the amino acids ornithine and arginine improve
this recipe. Her book Cure for All Cancers, contains 103 case histories of
her supposed cancer cures. However, judging from her descriptions (a) most
did not have cancer, and (b) of those that did, most had received standard
medical treatment or their tumors were in early stages.

Devices

Many types of devices are used with unfounded claims that they are effective
against cancer. These include devices that pass low-voltage electrical
current through tumors or the body, "electroacupuncture" devices purported
to measure the electrical resistance of "acupuncture points," electrical
devices claimed to "charge" blood samples taken from patients and later
reinjected, negative ion generators claimed to have an effect against
tumors, radionics devices claimed to diagnose and cure cancer by analyzing
and emitting radio waves at the correct frequencies, magnets claimed capable
of curing cancers by "improving circulation" or by intracellular effects,
and projectors of colored light claimed to exert healing effects [13].

Essiac

Essiac is an herbal remedy that was prescribed and promoted for about 50
years by Rene M. Caisse, a Canadian nurse who died in 1978. Shortly before
her death, she turned over the formula and manufacturing rights to the
Resperin Corporation, a Canadian company that has provided it to patients
under a special agreement with Canadian health officials. Several reports
state that the formula contains burdock, Indian rhubarb, sorrel, and
slippery elm, but there may be additional ingredients. Essiac tea claimed to
be Caisse's original formulation is also marketed in the United States.
Several animal tests using samples of Essiac have shown no antitumor
activity. Nor did a review of data on 86 patients performed by the Canadian
federal health department during the early 1980s [14].

<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/cellular.html>
Fresh Cell Therapy

Fresh cell therapy, also called live cell therapy or cellular therapy,
involves injections of fresh embryonic animal cells taken from the organ or
tissue that corresponds to the unhealthy organ or tissue in the patient.
Proponents claim that the recipient's body automatically transports the
injected cells to the target organ where they repair and rejuvenate the
ailing cells. The American Cancer Society states that fresh cell therapy has
no proven benefit and has caused serious side effects (infections and
immunologic reactions to the injected protein) and death [15]. In 1984, The
FDA issued an Import Alert asking the U.S. Customs and Postal Services to
block the importation of all "cell therapy" powders and extracts intended
for injection.

Gerson Method

Proponents of the Gerson diet claim that cancer can be cured only if toxins
are eliminated from the body. They recommend "detoxification" with frequent
coffee enemas and a low-sodium diet that includes more than a gallon a day
of juices made from fruits, vegetables, and raw calf's liver. This method
was developed by Max Gerson, a German-born physician who emigrated to the
United States in 1936 and practiced in New York City until his death in
1959. Gerson therapy is still available at Hospital Meridien in Tijuana,
Mexico and, since February 1997, at the Gerson Healing Center in Sedona,
Arizona.

Gerson therapy is still actively promoted by his daughter, Charlotte Gerson,
through lectures, talk show appearances, and publications of the Gerson
Institute in Bonita, California. Gerson protocols have included liver
extract injections, ozone enemas, "live cell therapy," thyroid tablets,
royal jelly capsules, linseed oil, castor oil enemas, clay packs, laetrile,
and vaccines made from influenza virus and killed Staphylococcus aureus
bacteria.

In 1947, the NCI reviewed ten cases selected by Dr. Gerson and found his
report unconvincing. That same year, a committee appointed by the New York
County Medical Society reviewed records of 86 patients, examined ten
patients, and found no evidence that the Gerson method had value in treating
cancer. An NCI analysis of Dr. Gerson's book A Cancer Therapy: Results of
Fifty Cases concluded in 1959 that most of the cases failed to meet the
criteria (such as histologic verification of cancer) for proper evaluation
of a cancer case [16]. A recent review of the Gerson treatment rationale
concluded: (a) the "poisons" Gerson claimed to be present in processed foods
have never been identified, (b) frequent coffee enemas have never been shown
to mobilize and remove poisons from the liver and intestines of cancer
patients, (c) there is no evidence that any such poisons are related to the
onset of cancer, (d) there is no evidence that a "healing" inflammatory
reaction exists that can seek out and kill cancer cells [17].

Between 1980 and 1986 at least 13 patients treated with Gerson therapy were
admitted to San Diego area hospitals with Campylobacter fetus sepsis
attributable to the liver injections [18]. None of the patients was
cancer-free, and one died of his malignancy within a week. Five were
comatose due to low serum sodium levels, presumably as a result of the "no
sodium" Gerson dietary regimen. As a result, Gerson personnel modified their
techniques for handling raw liver products and biologicals. However, the
Gerson approach still has considerable potential for harm. Deaths also have
been attributed to the coffee enemas administered at the Tijuana clinic.

Charlotte Gerson claims that treatment at the clinic has produced high cure
rates for many cancers. In 1986, however, investigators learned that
patients were not monitored after they left the facility [19]. Although
clinic personnel later said they would follow their patients systematically,
there is no published evidence that they have done so. A naturopath who
visited the Gerson Clinic in 1983 was able to track 21 patients over a
5-year period (or until death) through annual letters or phone calls. At the
5-year mark, only one was still alive (but not cancer-free); the rest had
succumbed to their cancer [20].

<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/greek.html> Greek
Cancer Cure

The principal proponent of the Greek Cancer Cure was microbiologist Dr.
Hariton-Tzannis Alivizatos, of Athens, Greece, who died in 1991. He claimed
to have a blood test that could determine the type, location, and severity
of any cancer. He also asserted that his "serum" enabled the patient's
immune system to destroy cancer cells, and helped the body rejuvenate parts
destroyed by cancer. Knowledgeable observers believe that the principal
ingredient of the so-called Greek Cancer Cure was niacin. The American
Cancer Society and the NCI asked Alivizatos several times for detailed
information on his methods, but he never replied [21].


Hoxsey
<http://www.quackwatch.org/01QuackeryRelatedTopics/OTA/ota04.html#Hoxsey>
Treatment


Naturopath Harry Hoxsey promoted an herbal treatment consisting of an
externally used paste or powder and a tonic taken orally. The external
preparations contained corrosive agents such as arsenic sulfide. The
internal medicine, said to be adjusted on a case-by-case basis, contained
potassium iodide and such things as red clover, licorice, burdock root,
Stillingia root, Berberis root, pokeroot, cascara, prickly ash bark, and
buckthorn bark. Hoxsey said that the formulas were developed in 1840 by his
great grandfather and passed to him by his father while the latter was dying
of cancer.

Hoxsey's treatment was offered at clinics in the United States from 1924
until repeated clashes with the FDA led him to close his main clinic in
Dallas in the late 1950s. In 1963, Hoxsey's former chief nurse Mildred
Nelson began offering it at a clinic in Tijuana, Mexico [22]. Hoxsey himself
contracted prostate cancer in 1967 and underwent surgery after treating
himself unsuccessfully with his tonic. Most of the herbs in the tonic have
been tested for antitumor activity in cancer, with negligible results for a
few and no results for the others. Some of these herbs, most notably
pokeroot, have toxic side effects. The NCI evaluated case reports submitted
by Hoxsey and concluded that no assessment was possible because the records
did not contain adequate information [23]. Hoxsey died in 1974. Nelson died
in January 1999.

<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/hydrazine.html>
Hydrazine Sulfate

In the mid-1970s, hydrazine sulfate was proposed for treating the
progressive weight loss and debilitation characteristic of advanced cancer.
Based on animal data and preliminary human studies, it has also been claimed
to cause tumor regression and subjective improvement in patients. However,
three recent trials sponsored by the National Cancer Institute demonstrated
no benefit attributable to hydrazine sulfate [24-26]. The trials involved
243 patients with newly diagnosed non-small cell lung cancer, 266 patients
with advanced non-small cell lung cancer, and 127 patients with advanced
colorectal cancer. The largest of the three found that nerve damage occurred
more often and that quality of life was significantly worse in the hydrazine
sulfate group. After these studies were published, proponents claimed that
they were flawed because patients were permitted to ingest tranquilizers,
barbiturates, or alcohol, which allegedly would nullify the effect of
hydrazine sulfate. The National Cancer Institute rejected these concerns,
and an investigation by United States General Accounting Office found no
difference in survival times between the patients who had taken these drugs
and those who had not [27]. In December 2000, the Annals of Internal
Medicine published a case report of a 55-year-old man with cancer of the
sinus near his left cheekbone. Instead of undergoing recommended medical
treatment, he obtained hydrazine sulfate through a Web site and, for four
months, followed the regimen published on the kathykeeton.com Web site. Two
weeks later, he was hospitalized with signs of kidney and liver failure.
Despite intensive hospital care, he died within a week [28,29].

<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/oxygen.html>
"Hyperoxygenation" Therapies

"Hyperoxygenation" therapy -- also called "bio-oxidative therapy" and
"oxidative therapy" -- is based on the erroneous concept that cancer is
caused by oxygen deficiency and can be cured by exposing cancer cells to
more oxygen than they can tolerate. The most touted agents are hydrogen
peroxide, germanium sesquioxide, and ozone. Although these compounds have
been the subject of legitimate research, there is little or no evidence that
they are effective for the treatment of any serious disease, and each has
demonstrated potential for harm [30]. Germanium products have caused
irreversible kidney damage and death [31]. The FDA has
<http://www.fda.gov/ora/fiars/ora_import_ia5407.html> banned their
importation and seized products from several U.S. manufacturers.

<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/iat.html>
Immuno-augmentative Therapy

Immuno-augmentative therapy (IAT) was developed by Lawrence Burton, Ph.D., a
zoologist who claimed he could stimulate the immune system's natural ability
to detect and destroy cancer cells. He claimed to accomplish this by
injecting protein extracts isolated with processes he had patented. However:
(a) the immune system does not detect and destroy cancer cells as Burton
postulated, and (b) the substances he claimed to use cannot be produced by
the procedures described in his patent applications and have not been
demonstrated to exist in the human body [32].

NCI scientists who analyzed IAT treatment materials given to several
patients concluded that the materials were dilute solutions of ordinary
blood proteins, primarily albumin. None were electrophoretically pure, and
none contained Burton's postulated components. Burton did not publish
detailed clinical reports, divulge to the scientific community the details
of his methods, publish meaningful statistics, conduct a controlled trial,
or provide independent investigators with specimens of his treatment
materials for analysis. During the mid-1980s, several of his patients
developed serious infections following IAT [33].

In 1980, CBS-TV's "60 Minutes" gave Burton a tremendous publicity boost when
a prominent physician stated that one of his patients appeared to have
recovered miraculously with Burton's treatment. Although the patient died of
his cancer twelve days after the program was shown, "60 Minutes" refused to
inform viewers of this fact. In 1986, the Congressional Office of Technology
Assessment assembled a group of technical experts and representatives of
Burton to design a clinical trial to evaluate IAT. However, communication
between Burton and U.S. government authorities broke down after he insisted
that a "pre-test" be conducted at his clinic [34]. Burton died in 1993, but
the clinic is still operating.

Iscador

Iscador is an extract of mistletoe
<http://www.cancer.gov/cancertopics/pdq/cam/mistletoe> first proposed for
the treatment of cancer in 1920 by Rudolph Steiner (1861-1925), who espoused
many occult beliefs. Steiner founded the Society for Cancer Research to
promote mistletoe extracts and occult-based practices he called
anthroposophical medicine. A 1962 report by the society claimed that the
time of picking the plants was important because they react to the
influences of the sun, moon, and planets. Various mistletoe juice
preparations have been studied with the hope of finding an effective
anticancer agent. However, in 1984, the expert working group of the Swiss
Society for Oncology concluded that there was no evidence that Iscador was
effective against human cancers [35]. To date, more than 30 clinical studies
have investigated imistletoe as a cancer treatment. The National Cancer
Institute has concluded: "Reports of improved survival and/or quality of
life have been common, but nearly all of the studies had major weaknesses
that raise doubts about the reliability of the findings." [36]

Kelley/Gonzalez
<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/kg.html>
Metabolic Therapy

In the 1960s, William Donald Kelley, D.D.S., developed a program for cancer
patients that involved dietary measures, vitamin and enzyme supplements, and
computerized "metabolic typing." Kelley classified people as "sympathetic
dominant," "parasympathetic dominant," or metabolically "balanced" and made
dietary recommendations for each type. He claimed that his "Protein
Metabolism Evaluation Index" could diagnose cancer before it was clinically
apparent and that his "Kelley Malignancy Index could detect "the presence or
absence of cancer, the growth rate of the tumor, the location of the tumor
mass, prognosis of the treatment, age of the tumor and the regulation of
medication for treatment."

In 1970, Kelley was convicted of practicing medicine without a license after
witnesses testified that he had diagnosed lung cancer on the basis of blood
from a patient's finger and prescribed dietary supplements, enzymes, and a
diet as treatment. In 1976, following court appeals, his dental license was
suspended for five years [37]. However, he continued to promote his methods
until the mid-1980s through his Dallas-based International Health Institute.
Under the institute's umbrella, licensed professionals and "certified
metabolic technicians" throughout the United States would administer a
3,200-item questionnaire and send the answers to Dallas. The resultant
computer printout provided a lengthy report on "metabolic status" plus
detailed instructions covering foods, supplements (typically 100 to 200
pills per day), "detoxification" techniques, and lifestyle changes.

Treatment said to be similar is still provided today by Nicholas Gonzalez,
M.D., of New York City, who claims to have analyzed Kelley's records and
drafted a book about his findings. The manuscript was never published, but
experts who evaluated its chapter on 50 cases found no evidence of benefit.
Gonzalez says that he offers "10 basic diets with 90 variations" and
typically prescribes coffee enemas and "up to 150 pills a day in 10 to 12
divided doses."

In 1994, after investigating six of Gonzalez's cases, New York State
licensing authorities had concluded: (a) his "alternative protocol" did not
entitle him to an alternative standard of care; (b) he had failed to
correctly interpret signs and symptoms of disease progression, (c) he had
treated the patients incompetently, and (d) his record-keeping was
inadequate. He placed on probation for three years with a stipulation that
he undergo retraining and his work be supervised by the Office of
Professional Conduct. [Download
<http://www.casewatch.org/board/med/gonzalez1994.pdf> documentation]

In 1997, a jury in New York City awarded $2.5 million in actual damages and
$150,000 in punitive damages to a former Gonzalez patient. The woman
testified that she had been diagnosed with an early stage of uterine cancer
in 1991 and underwent a hysterectomy. Instead of following through with
medically recommended radiation and chemotherapy, she consulted Gonzalez who
discouraged her from following her cancer specialist's advice. Based on his
interpretation of a hair test, Gonzalez prescribed up to 150 dietary
supplement pills a day plus frequent coffee enemas. Later he claimed that
the cancer was cured even though it was progressing. It eventually damaged
her spine and left her blind. An appeals court upheld the $2.5 million
verdict but dismissed the punitive damage award. In April 2000, a jury
awarded $282,000 in damages to the husband of a 40-year-old college
professor who had died of Hodgkin's disease in 1995. According to an article
in The New York Daily News, the jury found him negligent because he failed
to arrange "appropriate testing" to track the cancer, relying instead on an
unproven method of hair analysis [38].

<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/laetrile.html>
Laetrile

Laetrile, which achieved great notoriety during the 1970s and early 1980s,
is the trade name for a synthetic relative of amygdalin, a chemical in the
kernels of apricot pits, apple seeds, bitter almonds, and some other stone
fruits and nuts. Many laetrile promoters have called it "vitamin B17" and
falsely claimed that cancer is a vitamin deficiency disease that laetrile
can cure. Claims for laetrile's efficacy have varied considerably [39].
First it was claimed to prevent and cure cancer. Then it was claimed not to
cure, but to "control" cancer while giving patients an increased feeling of
well being. More recently, laetrile has been claimed to be effective, not by
itself, but as one component of "metabolic therapy" (described below).

Laetrile was first used to treat cancer patients in California in the 1950s.
According to proponents, it kills tumor cells selectively while leaving
normal cells alone. Although laetrile has been promoted as safe and
effective, clinical evidence indicates that it is neither [40]. When
subjected to enzymatic breakdown in the body, it forms glucose,
benzaldehyde, and hydrogen cyanide [41]. Some cancer patients treated with
laetrile have suffered nausea, vomiting, headache and dizziness, and a few
have died from cyanide poisoning. Laetrile has been tested in at least 20
animal tumor models and found to have no benefit either alone or together
with other substances. Several case reviews have found no benefit for the
treatment of cancer in humans.

In response to political pressure, a clinical trial was begun in 1982 by the
Mayo Clinic and three other U.S. cancer centers under NCI sponsorship.
Laetrile and "metabolic therapy" were administered as recommended by their
promoters. The patients had advanced cancer for which no proven treatment
was known. Of 178 patients, not one was cured or stabilized, and none had
any lessening of any cancer-related symptoms. The median survival rate was
about five months from the start of therapy. In those still alive after
seven months, tumor size had increased. Several patients experienced
symptoms of cyanide toxicity or had blood levels of cyanide approaching the
lethal range [42].

In 1975, a class action suit was filed to stop the FDA from interfering with
the sale and distribution of laetrile. Early in the case, a federal district
court judge in Oklahoma issued orders allowing cancer patients to import a
six-month supply of laetrile for personal use if they could obtain a
physician's affidavit that they were "terminal." In 1979, the U.S. Supreme
Court ruled that it is not possible to be certain who is terminal and that
even if it were possible, both terminally ill patients and the general
public deserve protection from fraudulent cures. In 1987, after further
appeals were denied, the district judge (a strong proponent of laetrile)
finally yielded to the higher courts and terminated the affidavit system
[39]. Few sources of laetrile are now available within the United States,
but it still is utilized at several Mexican clinics.

Livingston-Wheeler Regimen

Virginia C. Livingston, M.D., who died in 1990, postulated that cancer is
caused by a bacterium she called Progenitor cryptocides, which invades the
body when "immunity is stressed or weakened." She claimed to combat this by
strengthening the body's immune system with vaccines (including one made
from the patient's urine); "detoxification" with enemas; digestive enzymes;
a vegetarian diet that avoided chicken, eggs, and sugar; vitamin and mineral
supplements; visualization; and stress reduction. She claimed to have a very
high recovery rate but published no clinical data to support this.
Scientists who attempted to isolate the organism she postulated found that
it was a common skin bacterium. Researchers at the University of
Pennsylvania Cancer Center compared 78 of its patients with similar patients
treated at the Livingston-Wheeler Clinic. All had advanced cancers for which
no proven treatment was known. As expected, the study found no difference in
average survival time of the two groups. However, Livingston-Wheeler
patients reported more appetite difficulties and pain [43]. The treatment
Livingston originated is now offered at the Livingston Foundation Medical
Center in San Diego.

Macrobiotics
<http://www.quackwatch.org/01QuackeryRelatedTopics/OTA/ota03.html#macrobioti
c>

Macrobiotics is a quasireligious philosophical system that advocates a
semivegetarian diet. ("Macrobiotic" means "way of long life.") Macrobiotic
diets have been promoted for maintaining general health and for preventing
and "relieving" cancer and other diseases. The optimal diet is said to
balance "yin" and "yang" foods. It is composed of whole grains (50 to 60% of
each meal), vegetables (25 to 30% of each meal), whole beans or
soybean-based products (5 to 10% of daily food), nuts and seeds (small
amounts as snacks), miso soup, herbal teas, and small amounts of white meat
or seafood once or twice weekly. Some macrobiotic diets contain adequate
amounts of nutrients, but others do not.

Macrobiotic practitioners may base their recommendations on "pulse
diagnosis" and other unscientific procedures related to Chinese medicine
[44]. Pulse diagnosis supposedly involves six pulses at each wrist that
correspond to twelve internal spheres of bodily function. Other diagnostic
methods include "ancestral diagnosis," "astrological diagnosis," "aura and
vibrational diagnosis," "environmental diagnosis" (including consideration
of celestial influences" and tidal motions), and "spiritual diagnosis" (an
evaluation of "atmospheric vibrational conditions" to identify spiritual
influences, including "visions of the future").

Today's leading proponent is Michio Kushi, founder and president of the
Kushi Institute in Brookline, Massachusetts. According to Institute
publications, the macrobiotic way of life should include chewing food at
least 50 times per mouthful (or until it becomes liquid), not wearing
synthetic or woolen clothing next to the skin, avoiding long hot baths or
showers, having large green plants in your house to enrich the oxygen
content of the air, and singing a happy song every day. Kushi claims that
cancer is largely due to improper diet, thinking, and way of life, and can
be influenced by changing these factors. He recommends yin foods for cancers
due to excess yang, and yang foods for tumors that are predominantly yin.
His books contain case histories of people whose cancers have supposedly
disappeared after they adopted macrobiotic eating. However, the only reports
of efficacy are testimonials by patients, many of whom received responsible
therapy [45]. The diet itself can cause cancer patients to undergo serious
weight loss [46]. In July 2001, Kushi's wife and colleague Aveline died of
cervical cancer. According to an Associated Press obituary, she underwent
standard radiation treatment when the cancer was discovered. When the cancer
spread to her bones and she was told that no standard treatment was
available, relied on acupuncture and "Eastern" methods [47].

<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/manner.html>
Metabolic Therapy

Proponents of "metabolic therapy" claim to diagnose abnormalities at the
cellular level and correct them by normalizing the patient's metabolism.
They regard cancer, arthritis, multiple sclerosis, and other "degenerative"
diseases as the result of metabolic imbalance caused by a buildup of "toxic
substances" in the body. They claim that scientific practitioners merely
treat the symptoms of the disease while they treat the cause by removing
"toxins" and strengthening the immune system so the body can heal itself.
The "toxins" are neither defined nor objectively measurable. "Metabolic"
treatment regimens vary from practitioner to practitioner and may include a
"natural food" diet, coffee enemas, vitamins, minerals, glandulars, enzymes,
laetrile, and various other nostrums that are not legally marketable in the
United States. No scientific study has ever shown that "metabolic therapy"
or any of its components is effective against cancer or any other serious
disease.

The most visible proponent of "metabolic therapy" was Harold Manner, Ph.D.,
a biology professor who announced in 1977 that he had cured cancer in mice
with injections of laetrile, enzymes, and vitamin A. (Actually, he digested
the tumors by injecting them with digestive enzymes, which cannot cure
cancers that have metastasized.) During the early 1980s, Manner left his
teaching position and became affiliated with a clinic in Tijuana, Mexico.
Although he claimed a 74% success rate in treating cancers, there is no
evidence that he kept track of patients after they left his clinic [48]. He
died in 1988, but the clinic is still operating.

Pau D'arco

Pau d'arco tea, sold through health food stores and by mail, is also called
taheebo, lapacho, lapacho morado, ipe roxo, or ipes. The tea is claimed to
be an ancient Inca Indian remedy prepared from the inner bark of various
species of Tabebuia, an evergreen tree native to the West Indies and Central
and South America. However, stories about its origins contain geographic and
botanical errors. Proponents claim that pau d'arco tea is effective against
cancer and many other ailments. Tabebuia woods contains lapachol, which has
been demonstrated to have antitumor activity in a few animal tumor models.
However, no published study has shown a significant effect on cancer in
humans. Studies during the early 1970s found that lapachol is not as readily
absorbed by humans as by rats, and that plasma levels high enough to
influence tumors would be accompanied by anticoagulant effects. Even low
doses can cause nausea and vomiting and can interfere with blood clotting
[49]. Some researchers believe that lapachol should be studied further using
vitamin K to inhibit its anticoagulant activity .

Psychic Surgery

Psychic surgery is claimed to remove tumors without leaving a skin wound.
Actually, its practitioners use sleight-of-hand to create the illusion that
surgery is being performed. A false finger or thumb may be used to store a
red dye that appears as "blood" when the skin is "cut." Animal parts or
cotton wads soaked in the dye are palmed and then exhibited as "diseased
organs" supposedly removed from the patient's body. (However, one Philippine
"healer" has been reported to use human blood
<http://www.mja.com.au/public/issues/xmas/letters/roffey.html> , which
raises the possibility that HIV or hepatitis B could be transmitted.) The
American Cancer Society has concluded that "all demonstrations to date of
psychic surgery have been done by various forms of trickery." [50] Most
"psychic surgeons" practice in the Philippines or Brazil, but some have made
tours within the United States. A few have been prosecuted for theft and/or
practicing medicine without a license [51].

Psychologic Methods

Various psychologic methods are being promoted to cancer patients as cures
or adjuncts to other treatment. The techniques include imagery,
visualization, meditation, progressive muscle relaxation, and various forms
of psychotherapy. These techniques may reduce stress, alleviate depression,
help control pain, and enhance patients' feelings of mastery and control.
Individual and group support can have a positive impact on quality of life
and overall attitude. A positive attitude may increase a patient's chance of
surviving cancer by increasing compliance with proven treatment. However, it
has not been demonstrated that emotions directly influence the course of the
disease.

Bernie Siegel, M.D., author of Love, Medicine & Miracles and Peace, Love &
Healing, claims that "happy people generally don't get sick" and that "one's
attitude toward oneself is the single most important factor in healing or
staying well." Siegel also states that "a vigorous immune system can
overcome cancer if it is not interfered with, and emotional growth toward
greater self-acceptance and fulfillment helps keep the immune system
strong." However, he has published no scientific study supporting these
claims. A 10-year study co-authored by Siegel found that 34 breast cancer
patients participating in his program did not live longer after diagnosis
than comparable nonparticipants. The program consisted of weekly peer
support and family therapy, individual counseling, and the use of positive
imagery [52]. In November 1998, Siegel sent a series of email messages to
Dr. Barrett in which he said that the study bearing his name had been done
by a student and was improperly designed.

O. Carl Simonton, M.D., claims that cancers can be affected by relaxation
and visualization techniques. He claims that this approach can lessen fears
and tension, strengthen the patient's will to live, increase optimism, and
alter the course of a malignancy by strengthening the immune system.
However, he has not published the results of any well-designed study testing
his ideas. Simonton theorizes that the brain can stimulate endocrine glands
to inspire the immune system to attack cancer cells. He and his wife
Stephanie (a psychotherapist) taught cancer patients to imagine their cancer
being destroyed by their white blood cells. However, there is no evidence
that white cells actually attack cancer cells in this manner or that "immune
suppression" is a factor in the development of common cancers.

Simonton's book Getting Well Again included reports on patients who got
better after using his methods. However, an analysis of five of the reports
that might seem most impressive to laypersons noted that two of the patients
had undergone standard treatment, one had a slow-growing tumor, and one
probably did not have cancer. The fifth patient's tumor was treatable by
standard means [53].

Some people suggest that Simonton's program may have positive effects by
helping people to relax and to feel that they are "doing something"
positive. Although his approach is physically harmless, it can waste
people's time and money and encourage some to abandon effective care. It can
also cause people to feel ashamed or guilty that some inner inadequacy
caused them to develop cancer and is interfering with their recovery.
Patients seeking a support program should select one that is based on
scientific principles and has competent professional supervision.

Revici Cancer Control

Revici Cancer Control (also called lipid therapy and "biologically guided
chemotherapy") is based on the notion that cancer is caused by an imbalance
between constructive ("anabolic") and destructive ("catabolic") body
processes. Its main proponent, Emanuel Revici, M.D., prescribed lipid
alcohols, zinc, iron, and caffeine, which he classified as anabolic, and
fatty acids, sulfur, selenium, and magnesium, which he classified as
catabolic. His formulations were based on his interpretation of the specific
gravity, pH (acidity), and surface tension of single samples of the
patient's urine. Scientists who have offered to evaluate Revici's methods
were unable to reach an agreement with him on procedures to ensure a valid
test [54]. However, his method of urinary interpretation is obviously not
valid. The specific gravity of urine reflects the concentration of dissolved
substances and depends largely on the amount of fluid a person consumes. The
acidity depends mainly on diet, but varies considerably throughout the day.
Thus, even when these values are useful for a metabolic determination,
information from a single urine sample would be meaningless. The surface
tension of urine has no medically recognized diagnostic value. In 1993,
following a lengthy struggle with New York State licensing authorities,
Revici's medical license was permanently revoked. He died in January 1998 at
the age of 101. His treatment is still available at the Revici Life Sciences
Center, which reportedly is overseen by Keith Korins, M.D., and Revici's
niece.


714X <http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/714x.html>


714X is a chemical solution produced in Quebec by Gaston Naessens, who also
operates the International Academy of Somatidian Orthobiology. He claims
that 714X can "fluidify the lymph" and "direct nitrogen into the cancerous
cells in order to stop their toxic secretions which block the organism's
defense system." 714X has been analyzed by the Canadian Health Protection
Branch and found to contain a mixture of camphor, ammonium chloride and
nitrate, sodium chloride, ethyl alcohol, and water. The Health Protection
Branch has received no scientific data to support claims that 714X can cure
cancer or AIDS. Its Expert Advisory Committee has deplored its use for these
purposes and warned that there could be adverse side effects [55]. In 1956,
in connection with alleged cancer remedy called GN-24, Naessens was
convicted of illegal medical practice and ordered by a French court to pay
the maximum applicable fine. He was prosecuted again in 1964 after another
alleged cancer remedy he administered in Corsica was proven not to work
[56].


Shark Cartilage


Powdered shark cartilage is purported to contain a protein that inhibits the
growth of new blood vessels needed for the spread of cancer. Although a
modest anti-angiogenic effect has been observed in laboratory experiments,
it has not been demonstrated that feeding shark cartilage to humans
significantly inhibits angiogenesis in patients with cancer. Even if direct
applications were effective, oral administration would not work because the
protein would be digested rather than absorbed intact into the body. (If the
proteins could enter the body, they would cause an immune response that
would make the individual allergic to them and could trigger disastrous
allergic responses with further exposure to the protein.)

Nevertheless, in the spring of 1993, "60 Minutes" aired a program promoting
the claims of biochemist/entrepreneur I. William Lane, Ph.D., author of the
book Sharks Don't Get Cancer. The program highlighted a Cuban study of 29
"terminal" cancer patients who received shark-cartilage preparations.
Narrator Mike Wallace filmed several of the patients doing exercise and
reported that most of them felt better several weeks after the treatment had
begun. The fact that "feeling better" does not indicate whether a cancer
treatment is effective was not mentioned. Nor was the fact that sharks do
get cancer, even of their cartilage. NCI officials subsequently reviewed the
Cuban data and concluded that they were "incomplete and unimpressive." [57]

In May 1997, at the American Society of Clinical Oncology's annual meeting,
researchers reported a study that found shark cartilage ineffective against
advanced cancer in adults with a life expectancy of at least 12 weeks. The
study followed 58 people who were prescribed oral doses of shark cartilage
as their only form of anti-cancer treatment. After 12 weeks, none achieved a
complete or partial response to the shark cartilage treatment. Only ten
showed no progression of their cancer, and only two had a quantifiable
improvement in quality of life. (The fact that ten cancers did not progress
is not evidence that the shark cartilage was responsible for this. The
progression of cancer is not always rapid.) The researchers concluded:
"Shark cartilage was inactive in patients with advanced stages of cancer,
specifically in breast, colon, lung, and prostate cancer." The study was
sponsored by Cancer Treatment Research Foundation, Cartilage Technologies (a
manufacturer), and Cancer Treatment Centers of America. A few months later,
Cartilage Technologies announced that it would support no additional
research on shark cartilage as a cancer remedy [58].

Government agencies have taken action against at least three companies
marketing shark cartilage. In September 1997, the FDA warned Lane Labs-USA,
of Allendale, New Jersey, to stop claiming that its shark cartilage product
BeneFin can help fight cancer, arthritis, and psoriasis [59]. In December
1999, the U.S. Department
<http://www.quackwatch.org/04ConsumerEducation/News/shark.html> of Justice
filed a lawsuit intended to stop the company from continuing its illegal
marketing [60]. In 1998, the Federal Trade Commission obtained two consent
agreements barring unsubstantiated claims for shark-cartilage products.
Nutriveda, Inc <http://www.ftc.gov/os/1998/9806/9723071.htm> ., of Brooklyn,
New York, had claimed that its product Cardilet was effective against
cancer, rheumatism, arthritis, diabetes, fibroids, bursitis, circulatory
problems, and cysts. Body Systems
<http://www.ftc.gov/os/1999/9906/bodycmp.htm> Technology, of Castleberry,
Florida, had advertised that its product was effective against cancer. In
June 2000, the
<http://www.quackwatch.org/02ConsumerProtection/FTCActions/lane.html> FTC
announced that Dr. Lane and Lane Labs-USA had signed consent agreements to
stop illegal claims for Benefin and to pay $550,000 in penalties and $450
toward the cost of an approved clinical trial involving shark cartilage [61]

<http://www.quackwatch.org/01QuackeryRelatedTopics/Cancer/c.html> Vitamin C

The claim that vitamin C is useful in the treatment of cancer is largely
attributable to Linus
<http://www.quackwatch.org/01QuackeryRelatedTopics/pauling.html> Pauling,
Ph.D. During the mid-1970s, Pauling began claiming that high doses of
vitamin C are effective in preventing and curing cancer. In 1976 and 1978,
he and a Scottish surgeon, Ewan Cameron, reported that a group of 100
terminal cancer patients treated with 10,000 mg of vitamin C daily had
survived three to four times longer than historically matched patients who
did not receive vitamin C supplements [62-63]. However, Dr. William DeWys,
chief of clinical investigations at the NCI, found that the patient groups
were not comparable. The vitamin C patients were Cameron's, while the other
patients were managed by other physicians. Cameron's patients were started
on vitamin C when he labeled them "untreatable" by other methods, and their
subsequent survival was compared to the survival of the "control" patients
after they were labeled untreatable by their doctors. DeWys found that
Cameron's patients were labeled untreatable much earlier in the course of
their disease-which meant that they entered the hospital before they were as
sick as the other doctors' patients and would naturally be expected to live
longer [64]. Nevertheless, to test whether Pauling might be correct, the
Mayo Clinic conducted three double-blind studies involving a total of 367
patients with advanced cancer. All three studies found that patients given
10 g of vitamin C daily did no better than those given a placebo [65-67].
Despite many years of taking huge daily amounts of vitamin C, both Pauling
and his wife Ava died of cancer -- she in 1981 and he in 1994.

For Additional Information

The American Cancer Society (800 227-2345 or a local office) can supply
position papers on many questionable methods. Direct advice can be obtained
from the Candlelighters Childhood Cancer Foundation Ombudsman's program (301
657-8401), the Consumer Health Information Research Institute (816
228-4595), and the National Council Against Health Fraud (909 824-4690).

The NCI's Information Service (1-800-4-CANCER) answers questions and
provides literature about the latest cancer treatments, clinical trials, and
community services for patients and their families. Physicians can obtain
information on treatment protocols, results, and clinical trials through
NCI's Physician Data Query (PDQ), a computerized database that is updated
monthly. This enables most cancer patients to benefit from the latest
scientific knowledge without having to travel far. Neither the Cancer
Information Service nor the NIH Office of Alternative Medicine provides
detailed information on the safety or efficacy of questionable methods.

Unconventional
<http://www.quackwatch.org/01QuackeryRelatedTopics/OTA/ota00.html> Cancer
Treatments, is an excellent 300-page book issued 1990 by the Office of
Technology Assessment of the United States Congress. It is out of print but
is available on this web site.


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_______________

Portions of this article were published in the authors' chapter in Cancer
Medicine, 4th Edition, published by Williams & Wilkins (1996). Dr. Herbert
is Professor of Medicine, The Mount Sinai School of Medicine and Chief,
Hematology and Nutrition Research Laboratory, the Bronx Veterans Affairs
Medical Center.

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"Alternative" Cancer Treatments ||| Quackwatch Home Page
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This article was revised on July 6, 2001.





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