Chapter Twenty

PART FIVE

Physical, Traditional, and Pharmacological Therapies

Chapter Twenty

Unconventional Pharmacological Therapies–An Overview

Unconventional pharmacological therapies represent the largest and most diverse field of unconventional cancer treatments. Some are well-documented as being of value to cancer patients; others have no documentation whatsoever. In general, pharmacological therapies have attracted greater media attention than the quartet of spiritual, psychological, nutritional, and physical therapies that I have described in previous chapters. What differentiates pharmacological therapies most significantly from the quartet of health-promoting therapies is that pharmacological treatments do not have any obvious intrinsic health-promoting benefits. Prayer, psychotherapy and social support, eating healthy foods, relaxing, stretching, and exercising are all intrinsically health-promoting for most people. Taking a pill or an injection is neither intrinsically nor obviously good for your health, except insofar as the treatment is pharmacologically useful or engenders a positive placebo effect. (In fairness, this is also true of much of conventional cancer therapy.)

Thus pharmacological therapies, with no obvious direct health benefits, represent a much more complex and difficult field to evaluate than the health-promoting quartet of spiritual, psychological, nutritional, and physical therapies. It is a field where cancer quackery is not only more of a threat but in reality more prevalent. The proponents of alternative pharmacological therapies have also generated more intense opposition from mainstream medicine than have many of the proponents of “lifestyle therapies,” which were the√™primary themes of the earlier chapters. On the other hand, pharmacological therapies lend themselves to evaluation by randomized controlled double-blind prospective clinical trials in a way that the quartet of lifestyle therapies do not.

The Profit Potential of Pharmacological Therapies

One crucial fact about pharmacological therapies is that it is easier to make money from these therapies than it is from the quartet of health-promoting therapies. Of course, spiritual healers, psychotherapists, nutritional counselors, and the like are paid, and some charge exorbitant amounts for their services. But we all have some general idea of what learning healthy ways of living is worth to us. Moreover, the health-promoting therapies generally represent open therapies in which there are no special secrets. Open therapies create open markets which tend to keep prices within a reasonable range.

The intrinsic value of a pill or injection, however, is much more difficult to assess. The pharmacological agent has a magic to it precisely because it is not obviously health-promoting and therefore we do not know how it works. It depends upon the efficacy of some mysterious inner properties of the pharmacological agent. The secret is what draws us. And, in a sense, the greater and more mysterious the secret, the more reasonable it may appear that obtaining this elixir of life involves a certain monetary expense.

Pills are more easily made into commodities than lifestyle-based health- promoting therapies. They can be marked up more easily for higher profit margins. And, through the modern miracle of patents, potentially therapeutic pills and injections for cancer can be owned by companies or individuals who can charge for these agents whatever the market will bear.

The pharmaceutical industry is, obviously, a very powerful force in American science, medicine, business, and politics. The industry must make large profits to realize a return on investment, particularly in a regulatory system where it costs $100 to $200 million dollars to bring a new drug to market. In this environment, drugs that cannot be patented are of little financial interest to the industry. They can, in fact, represent a tangible financial threat if they compete in cost-effectiveness with profitable patented products. Even if a drug can be patented, the prospect that it may only help either a small number of solvent people or a large number of impoverished people can keep a company from marketing the drug. Such small-return products are known as “orphan drugs,” and Washington has worked hard to create incentives for bringing these drugs to market that counteract the natural market forces working in the other direction.

Producers of alternative cancer therapies that use pharmaceutical substances confront the same market forces that pharmaceutical companies do. Because the capacity to patent substances is not always available to the producers of some alternative therapies, many have reverted to the older medical tradition in which the critical ingredients of the medicine man’s potions were a trade secret, passed down from master to student. Harry Hoxsey, who popularized the Hoxsey remedy, is an example of this. In other cases, patents have been a possible way to protect the producer’s investment, and have been sought and obtained. The late Lawrence Burton in the Bahamas and Stanislaw Burzynski in Texas obtained patents for their treatments. Still other practitioners have offered an open pharmaceutical therapy which is available free, or at cost, or with only the smallest markup. Logically, one might think that treatments in this last category would be the most popular among alternative pharmacological therapies. But, in fact, it has been the secret therapies and the patented alternative pharmacological therapies that have attracted the most cancer patients, the most media interest, and the most mainstream opposition.

The “Great” Practitioners Who Claim Unique Success

A handful of practitioners of unconventional pharmacological cancer therapies are considered “great” by proponents and sympathetic analysts of alternative cancer therapies:

The late Lawrence Burton, Ph.D., in the Bahamas, who claimed that his secret patented Immuno-Augmentative Therapy controls some cancers.

Stanislaw Burzynski, M.D., Ph.D., in Texas, who claims that he hasêfound a peptide fraction in human urine that controls some cancers.

Joseph Gold, M.D., in Syracuse, New York, who believes that hydrazine sulfate can extend life with cancer.

Emanuel Revici, M.D., in New York, who claims his “physiologically guided chemotherapy” is effective in curing or controlling some cancers.

Gaston Naessens, in Quebec, who is known both for a remarkable microscope that he uses for diagnosis and for his claims of efficacy with pharmacological treatments for cancer and AIDS.

We have already discussed the work of two other “greats” of the alternative pharmacological therapy world in previous chapters: the double Nobel prize winner Linus Pauling, whose claims for the effectiveness of vitamin C in cancer are well known, and the late Virginia Livingston, who believed she had developed a cancer vaccine. These six men and one woman would generally be regarded as among the great minds of contemporary alternative pharmacological cancer therapies. There are certainly other candidates for this list, but this is a representative sample.

What do these practitioners of alternative pharmacological cancer therapies have in common? Some comparisons are of value, because collectively these practitioners seem to fit a deep archetypical need of many cancer patients to find an undiscovered genius with a scientifically based magic bullet that may cure or control their cancer. This is not to denigrate the need for a scientifically based cure in a culture that worships science. It is simply to acknowledge that many people in such a culture are unlikely to find spiritual, psychological, nutritional, physical, and traditional approaches to cancer sufficient.

What these seven practitioners have in common is that: (a) they are believed by their supporters to have developed a high-technology pharmaceutical treatment that is effective in curing or controlling at least some cancers; (b) with the important exceptions of Pauling, Gold, Livingston, and Burzynski, they have made relatively little recent effort to clarify their research for peer- reviewed medical journals; (c) despite (or possibly because of) the mystery or controversy surrounding their therapies, they are considered historical ge- niuses and are beloved by their patients and supporters; (d) they have or have had high media profiles in the alternative cancer press, the New Age press, and often the general media; (e) they have been placed (with the exception of Pauling and Gold) under extended legal challenge but, to date, have beaten back all efforts to stop them from practicing. Generally (the exceptions being Pauling and Gold) their therapies are very expensive or very inconvenient for most American patients to obtain.

“Open” and “Closed” Pharmacological Therapies

In chapter 8, describing a framework for evaluating alternative cancer therapies, I recommended that patients distinguish between “open therapies,” in which everything about the therapy is known and available to any investigator for assessment, and “closed” or “partially closed” therapies, in which the practitioner says, in effect, “I have a secret or unique system for curing or controlling cancer, and if you come to my center I will provide it to you.” Burton kept central components of his therapy explicitly secret. Naessens has explicitly kept his major diagnostic tool–a remarkable microscope–from being fully examined or reproduced. In contrast, Pauling, Gold, Livingston, and Burzynski have “scientifically open” therapies in the conventional sense of the term. Revici is a borderline case: while his frame of reference is so self-referential as to preclude simple evaluation, his therapy is sufficiently open to be called scientifically assessable.

Does this mean that practitioners who have closed or partially or “functionally” closed treatment systems have nothing to offer the informed cancer patient? Opinions differ. Advocates of these and other closed or partially or functionally closed therapies usually have elaborate rationales as to why the information which they claim could be invaluable to mankind is not being publicly shared. They point, for example, to the proprietary secrecy of pharmaceutical firms regarding some of their products. They say that, because of the hostility of mainstream institutions toward their favorite practitioner, he had no alternative but to protect his investment by a personal strategy of secrecy. Or else they argue that their favorite practitioner is protecting his therapy from a mainstream conspiracy to suppress cancer cures. They may also claim their favorite practitioner sought to offer his therapy for scientific evaluation but was ignored or persecuted (claims that are often true), so his current lack of interest in scientific evaluation is understandable. In some instances, as is the case for Revici, they may make the more justifiable claim that these practi-tioners have been willing to share their methods with the few physicians who have been willing to study intensively with them.

Most mainstream physicians and scientists, on the other hand, are disgusted by practitioners using unconventional pharmacological treatments who claim they have made a major advance in cancer therapy but are unwilling to submit their findings to the unmerciful scrutiny of full scientific review. Indeed, in my judgment, the “explanations” for why therapies must be kept secret–or are less than fully and completely described–lack a fundamental ethical basis. The arguments that justify a physician with a therapy that would genuinely help people with cancer in withholding it from scientific assessment are hard for most fair-minded people to comprehend. The fact that these arguments in support of secret “cancer cures” are so easily accepted by many proponents of alternative cancer therapies is, in my view, one of the most serious intellectual and moral deficiencies of the alternative cancer therapy culture.

Distinguishing between Therapy, Practitioner, and Service Delivery

In evaluating alternative therapies, I recommended in chapter 8 that one distinguish between the plausibility of the therapy itself, the credibility and character of the practitioner, and the quality of the service delivery. Rarely are these distinctions more useful than in evaluating a closed, expensive, or difficult-to-access alternative pharmacological therapy.

Lawrence Burton in the Bahamas–who thumbed his nose at the mainstream medical world and happily admitted to keeping part of his Immuno-Augmentative Therapy secret–had a very smooth and fairly expensive service delivery. Stanislaw Burzynski in Texas, who has sought to play the scientific game of open evaluation of his therapy, also has a smooth and very expensive service delivery. Revici in New York who, in his mid-nineties, long ago stopped publishing significant scientific articles in mainstream journals but who previously wrote an enormous scientific volume on his therapy, has a service delivery that is not expensive but that is described by many patients as being seriously disorganized. For many patients, such disorganization represents as serious an access problem as financial or geographical barriers. Naessens in Quebec, who has gone his own way in a small, remote Quebec town with Gallic disdain, makes a significant effort to explain many elements of his therapy to those who are interested, but holds the microscope as a proprietary device. In the face of legal challenges, his capacity to deliver services has been seriously compromised.

What is really fascinating about these practitioners is how extraordinarily famous their work is in the field of unconventional cancer therapies. In the preceding sections, we have seen that a considerable number of open and reasonably inexpensive “lifestyle therapies” are available to cancer patients. But many people with cancer are, understandably, seeking the magic bullet or the extra leverage beyond lifestyle therapy alone. Or they feel either disinclined or unable to follow the spiritual-psychological-nutritional-physical path.

Of profound interest psychologically is that, for the most part, an inverse relationship exists between the openness of the alternative pharmacological therapies and the level of public interest in the therapy. One would expect that the most open and most evaluated therapies would be the most interesting to patients. Pauling’s work with vitamin C and Gold’s work with hydrazine sulfate have received extensive independent assessment, both critical and supportive. What their therapies also have in common is that they make relatively modest claims about controlling cancer, yet their treatments generally draw less attention than the closed, expensive pharmacological treatments. At the other end of the spectrum, Lawrence Burton long resisted scientific assessment of his work, including an intensive effort by the Office of Technology Assessment in 1990 to develop a protocol acceptable to Burton for assessing his therapy. (Burton and his associates would have disagreed with my assessment on this point.) Despite the secrecy in which he enveloped his therapy, Burton was arguably the best known of all these practitioners.

Burzynski represents a partial exception to this postulated inverse relationship between scientific openness and fame: he has made his therapy available for independent assessment and he is almost as well known as Burton. Revici and Livingston represent middle cases. They make extensive claims for cure or control of cancer and have made their therapies available for scientific assessment, although relatively little has been done to evaluate their claims.

Lawrence Burton was also my favorite example of what a “secret magic bullet” therapy has to offer for people who do not look forward to lives of vegetarian diet, meditation, yoga, qi gong, acupuncture, and the rest. He told his patients that they can eat vegetarian diets if they like, because it means there will be more steak left for him and his friends, but that his therapy works as well or better with meat eaters. He encouraged his patients to enjoy their steaks, have a few drinks, and not to worry overmuch about smoking unless they have lung cancer. And since he was situated in the Bahamas, his patients were living in a resort setting. For a New York businessman diagnosed with a life-threatening cancer who has been a meat eater, social drinker, and smoker all his life, who believes in high-technology medicine, and who has little use for vegetarianism, meditation, and prayer, Lawrence Burton’s clinic began to look pretty good when he considered the alternatives. And when the New Yorker went down to the attractive Bahamian clinic and found himself surrounded by patients who believed they were doing well on Burton’s therapy, it was not difficult for him to feel encouraged, to have real hope, and to come to share the common perception of Burton’s patients that Burton is a genius.

Because so much has been written–and is readily available for the interested reader–about all of these “great” proponents of alternative cancer therapies, I have used as a criterion for inclusion in this book the scientific openness of the therapies. For this reason, I do not discuss Lawrence Burton or Gaston Naessens, intriguing though they are. Others have written readily available accounts of their therapies. I have already discussed Linus Pauling and Virginia Livingston. In the following chapters I discuss Stanislaw Burzynski, Joseph Gold, and Emanuel Revici.