Nicholas Gonzalez' response to the failed trial of the Gonzalez protocol: Disingenuous nonsense

Pity poor Nick Gonzalez.

Sorry, I couldn't resist. After having used the same line when discussing the hugely enjoyable humiliation of the Godfather of HIV/AIDS denialism, Peter Duesberg, I couldn't resist using the same line to introduce my response to Dr. Gonzalez's woo-ful whine in response to the publication of the disastrous (for him and any patient unfortunate enough to be in the arm receiving his protocol) clinical trial that demonstrated about as unequivocally as it is possible to demonstrate that his "protocol" to treat pancreatic cancer is nothing more than as steaming and stinking a pile of excrement as the, well, "results" of the twice daily coffee enemas that are a part of his treatment, along with all sorts of raw vegetable juices and 150 supplement pills a day.

The first thing I have to wonder upon seeing this, which several of you sent to me and one or two others posted as comments, is: What took Dr. Gonzalez so long? After all, the Journal of Clinical Oncology article reporting the results of the study of the Gonzalez protocol versus the standard of care at the time, gemcitabine chemotherapy, was published nearly a month ago online. Complete and utter silence reigned; that is, until Kimball Atwood, Steve Novella, and yours truly posted deconstructions of this study and pointed out how it should, if there is any science left in academic medicine (or, if you're a believer, if there's a just and righteous God in heaven), be the last nail in the coffin of the misbegotten magical, mystical hodge-podge of woo known as the Gonzalez therapy, which turned out to be worse than useless.

It looks as though ol' Nick is trying to take a crowbar to the coffin and pry open the cover. He begins, appropriately enough, by trying to throw the principal investigator of the study, Dr. John Chabot, under the bus, just as Chabot threw Gonzalez under the bus by publishing the JCO article in the first place:

Recently, to our astonishment we learned that the Journal of Clinical Oncology, considered to be one of the pre-eminent oncology journals in the country, published an article about our NCI-NIH clinical study which claimed that chemotherapy worked better than our treatment with patients diagnosed with inoperable pancreatic cancer.

Though I originally earned the grant from the NCI in 1998, though I was an investigator on this study throughout its existence, and though the clinical trial was set up to compare the efficacy of my treatment with chemotherapy, no one involved with the publication - not the Principal Investigator, Dr. John Chabot of Columbia Presbyterian Medical Center, nor any of his associates, informed me of their intent to publish this article, nor had I seen it. I learned of it serendipitously when the online version appeared on PubMed.

I suppose it's possible that Gonzalez was so out of the loop that he was unaware that the paper was about to be published, but I tend to doubt it. He's clearly known that the study was not going to make him look favorable for quite a while, so much so that he has written a book, and had a chapter pre-written and ready to run outlining all the evils he perceives in the study and how it is so badly designed and run, not to mention totally unfair to him. (He also in essence appears to admit elsewhere in his response that he was the one who sent the dogs after Dr. Chabot.) In response, Gonzalez has produced a huge pile of self-serving twaddle, mainly a lot of playing the martyr and complaining that it's all a conspiracy to make him look bad in order for the principal investigators to save their academic reputations. Actually, Gonzalez may have a point there that I might even agree with. True, it's just as self-serving of him to bring up this point, but it's the one comment he makes in the entire torrent of verbiage in his response and all the linked files that isn't utter twaddle:

In their official determination letter appearing on their website after a two-year investigation, the Office of Human Research Protections, the NIH agency in charge of investigating mismanagement on government funded studies, found that Dr. Chabot, who was in charge of admissions of patients, had improperly approved 42 out of a total of 62 patients, including 40 for whom he had failed to obtain appropriate written informed consent. Furthermore, the determination letter states that the Principal Investigator (Dr. Chabot) admitted he committed the managerial lapses, and in their letter the OHRP requires Columbia set up a program for training in appropriate research methodology - a serious indictment of a major academic medical center.

To my astonishment, the JCO article nowhere mentions the findings of the OHRP, as if this lengthy investigation never existed, leaving the reader with the impression this study was properly managed by Dr. Chabot. In that regard, the article is a gross misrepresentation of what actually transpired during the study's sad eight year history.

As glad as I was that the results of this idiotic trial had finally been reported, I did retain a bit of ambivalence about it. The reason is, as Dr. Gonzalez discusses, there is no mention of the ethical and regulatory lapses that plagued the trial. Worse, Dr. Chabot, who was clearly an opportunistic fool to have undertaken a trial that was so clearly unethical from the very beginning, bungled the administration of the trial to the point where the Office of Human Subjects Research Protections investigated and issued a determination letter outlining a litany of mismanagement, failure to obtain proper informed consent, and other problems. Finally, after the trial was stopped because it reached a predefined stopping point due to how poorly patients in the Gonzalez arm were doing compared to those in the chemotherapy arm, Dr. Chabot waited nearly four years to publish the results. It rather makes me wonder what happened earlier this year to prod him to submit the results of the trial for publication after all that time. A stench still lies over this whole misbegotten, unethical mess of a trial, and I don't like it that Dr. Chabot and his coinvestigators get a publication in a high impact clinical oncology journal like JCO to add to their CVs, even though I think the trial had to be published in a respectable journal in order to make sure that oncologists and other physicians take its results seriously.

That being said, the rest of Dr. Gonzalez's little hissy fit boils down to a heapin' helpin' of special pleading. But first he threatens Chabot with his patron of woo in Congress, Dan Burton, an antivaccine loon who is also most responsible for prodding the NIH to fund this trial of the Gonzalez protocol:

More recently, Congressman Dan Burton of Indiana and I have requested that the Inspector General of the Department of Health and Human Services begin an investigation to determine if the supervisors of the study committed fraud in the mishandling of the project and its data. We have learned, for example, that according to the published medical literature, Dr. Chabot, who as Principal Investigator should have been a completely neutral manager with no ties to either treatment being evaluated, had worked closely with his Columbia colleague developing the very GTX chemotherapy regimen used against us in the study - an obvious conflict of interest that had never been declared to us. We suspect Dr. Chabot believed it was in his best interest to discredit our alternative therapy and instead prove the value of a treatment he helped develop.

Ah, yes, the "pharma shill" gambit. Personally, I had a hard time finding much evidence to back up this charge. A PubMed search of Dr. Chabot's publications pulled up mostly articles about surgery, with only a couple of articles about neoadjuvant chemotherapy for pancreatic cancer. However, Gonzalez makes a lot of hay observing that partway through the trial the chemotherapy regimen used in the chemotherapy arm changed. The reason, of course, is that chemotherapy regimens were already evolving early during the course of the study. Gemcitabine alone had only resulted in marginal increases in survival; so it was quite reasonable to want to consider adding additional drugs. At the time the design of the trial was changed from a randomized trial to a nonrandomized design, a chemotherapy protocol known as GTX (Gemzar, Taxotere and Xeloda; Gemzar being the trade name for gemcitabine) had largely supplanted single agent gemcitabine protocols. Consequently, since only three patients had been enrolled, it made sense to change the chemotherapy arm to what was being given at the time at Columbia. Whether this change muddied up the trial (which it probably didn't; the trial was muddied up enough to begin with) or not, it's all a smokescreen thrown up by Gonzalez to distract attention from the fact that his therapy did no better than, in essence, untreated pancreatic cancer.

It's also rather illustrative of Dr. Gonzalez's "us against them" thinking for him to view someone as having a hopeless conflict of interest if he's ever studied chemotherapy before. Here's a clue: It is not a reportable "conflict of interest" to have studied before one modality that you're studying in a clinical trial now unless there's a financial interest in that modality. Academic surgeons and physicians study different drugs or treatments all the time. Just because they've studied one regimen doesn't make them hopelessly biased to the point where they are ineligible to head a clinical trial of that regimen against anything else. It would be one thing if Dr. Chabot had expressed unrelenting hostility to the Gonzalez protocol before, but he didn't. In fact, he put his reputation on the line to head up this study. Also, in marked contrast to Gonzalez's complaint, Dr. Chabot himself clearly knew CAM-speak pretty well, although he was unhappy over the change of the trial to a nonrandomized design.

Be that as it may, the main strategy for complaining about the clinical trial utilized by Gonzalez is special pleading. Before I get to that, note how vociferously Gonzalez complains about Chabot's referring patients he considered inappropriate for his trial. For example, Gonzalez points out that the patients who were to undergo the "nutritional" arm of the trial (a.k.a. the woo arm) had to be able to "eat normally." Well, that's cherry picking the best patients right there, because few patients with advanced pancreatic cancer can eat normally. I remember well Dr. Gonzalez's discussion of his initial series of 11 patients who underwent his protocol. He argued again and again that the long survival of these patients compared to historical controls could not be explained by selection bias, but in essence right here he is admitting that he relied on selection bias for his results. He even admits this later when he laments that the chemotherapy protocol, because chemotherapy was given intermittently and could thus be easily given to patients who couldn't eat while his regimen requires 150 pills a day and that even patients too ill to eat could receive the drugs in the chemotherapy regimen. Does Gonzalez realize that he's basically saying that chemotherapy can be given to sicker patients and that the only patients who can do his protocol are the patients who are in the best shape and thus most likely to live the longest, regardless of therapy? it's pure selection bias.

Gonzalez also complains ad nauseam that patients in the nutritional arm were not adequately screened for ability and motivation to follow the protocol. However, if one wants to avoid bias creeping into a trial, all patients would have to be screened using exactly the same criteria, regardless of which group they entered. That's really hard to do with a trial in which patients can choose which arm of the study they want to be in. The patients choosing the chemotherapy arm would quite reasonably ask why they should be screened for the Gonzalez protocol, and screening too closely those choosing the Gonzalez protocol would allow the very cherry picking of the least debilitated patients that must be avoided. Of course, part of me wonders whether investigators intentionally cut Gonzalez out of the patient qualification and selection process for this trial because they knew he'd try to cherry pick the best patients. I also note that self-selection would similarly tend to funnel the least debilitated and most motivated patients to the nutritional arm, which would in turn tend to mean that the patients most likely to survive the longest would be most likely to end up in that arm. In essence, you'd expect that there would be an apparent survival advantage in the nutritional for that reason alone, but the results of the study were exactly the opposite--resoundingly so. Whatever shortcomings there were in the design and administration of the trial, they were not enough to explain why the patients in the nutritional arm had a median survival of only 4.3 months, in essence the expected survival of patients with untreated advanced pancreatic cancer. Robbed of his ability to pick the best patients, Gonzalez's results were no better than no treatment at all, and certainly not the equal of chemotherapy.

Gonzalez reached his zenith of disingenuousness here:

Clinical trials lacking a lead-in period often - though not always - adopt an "intent-to-treat" format. With such a provision, researchers agree that all patients qualified and entered into the study for any of the treatments under scrutiny will be considered as having been treated, regardless if they actually proceed with the prescribed therapy or not. Though such an approach on first glance might not make much sense, researchers justify such an "intent-to-treat" rule as necessary to evaluate fully a new drug. For example, if in a study 100 patients receive some new medication but 50 drop out after a week because of serious side effects, certainly it would seem prudent to include these patients as treatment failures rather than discount them, since they quit because of some negative reaction to the drug. On the other hand, such a design can be disastrous for a lifestyle intervention trial such as ours, since patients who might initially be enthusiastic but who can't or choose not to proceed with the self-administered dietary/nutritional regimen will be counted as having been fully treated.

In essence, Gonzalez is engaging in special pleading here. He is saying that the normal guidelines for what constitutes good clinical research shouldn't apply to his protocol. Intent-to-treat analyses are very important because if a patient stops a treatment it can be because of disease progression or because the treatment is toxic or difficult. Either way, it's important to know. Gonzalez seems to think that "lifestyle interventions" should be exempt from such an analysis for...no reason whatsoever. Excluding patients who couldn't make it through Gonzalez's protocol, which is, as has been pointed out before, quite onerous, would introduce bias in that the more debilitated patients, who couldn't swallow 150 pills a day, along with the raw juices and various other dietary woo, and undergo coffee enemas twice a day, would be excluded, leaving patients in better shape for analysis.

I was also heartened, believe it or not to read that not a single oncologist referred a patient to the trial. This is truly good news because it tells me that there are actually still oncologists left in New York who haven't bought into CAM:

Ultimately, only the oncology team at Columbia cooperated in any way only after much prodding by Dr. Antman and Chabot, and only for the admission of chemotherapy subjects to form the comparison "control" arm as we shall see. Even for this group their referrals proved not helpful.

Oncologists not only refused to refer patients to the trial, but at times actively discouraged their patients who might express an interest from seeking entry. A number of candidates suitable for the study who had learned about our treatment on their own informed our office that their oncologist had strongly argued against considering the project. One well-known Memorial oncologist warned a candidate interested in joining the study that I was a "quack" and the study a "fraud."

Oncologists also frequently discouraged patients who actually entered the nutritional arm of the study from continuing with the prescribed regimen.

I'd love to know who that well-known Memorial Sloan Kettering Cancer Center oncologist was who called Gonzalez a quack and his trial a fraud, as I'd love to take him out to dinner and shake his hand. He called it exactly right, in my opinion. I'm also heartened that not even the oncology team at Columbia wanted anything to do with referring patients to this trial. It shows that there is at least some sanity at that institution. But it wasn't just that oncologist at MSKCC. There are a lot of oncologists like him:

Unfortunately, a protocol provision against which we argued and that ultimately caused enormous damage required that each patient assigned to the nutrition arm consult with a physician monthly for an examination and blood work. On the surface, such visits would hardly seem to be the source of potential catastrophe, since, one might think, how can a visit with a doctor be a problem? And trials involving chemotherapy drugs often require frequent physician assessments to monitor closely the toxic side effects of the medications being tested, such as severe anemia or immune suppression.

For those subjects who lived in the New York area, Dr. Isaacs and I could satisfy this rule by meeting with the patient ourselves monthly. We had no problem with such an arrangement, of course. But as it turned out, only three of the patients ultimately entered into the nutrition arm lived in the New York area, with the great majority residing at great distance. Consequently, nearly all subjects assigned to us for treatment were followed by a local doctor, most frequently an oncologist completely unfamiliar with our treatment approach and usually hostile toward it, with only a few exceptions.

Repeatedly, we heard from our patients that during the required monthly meetings, the local physicians aggressively discouraged them from continuing their treatment with us, instead urging them to proceed with some standard approach - despite the fact that the conventional therapies for inoperable pancreatic cancer have proven largely worthless.

Help, help, I'm being repressed!

Put yourself in the position of one of those oncologists. What would you do? You took an oath to do your best for patients. Your training correctly tells you that this ridiculous regimen advocated by Gonzalez is based on no science and indeed so incredibly unlikely to do any good that medical ethics demands that you try very hard to persuade your patients not to engage in a course of action that your professional knowledge and understanding of science tell you to be harmful. Make no mistake, even if the Gonzalez protocol did not hasten the deterioration of the patient, it put the patient through hell for no benefit. Dr. Gonzalez scoffs at doctors who pointed out to patients who chose the Gonzalez protocol that they were choosing to spend the last months of their lives following a restricted diet, swallowing 130-170 pills a day, and subjecting themselves to coffee enemas, a protocol that couldn't possibly help their disease, instead of enjoying themselves as much as they could with pizza and ice cream. I find nothing to criticize these doctors for; they were absolutely correct.

Finally, the most disturbing part of Dr. Gonzalez's defense of his protocol is his admission to something I alluded to as a possibility in my previous post, namely that perhaps there were differences in palliative care between the groups. One of the most common causes of death from pancreatic cancer is biliary sepsis, namely infection of the backed up bile that accumulates behind the bile duct obstruction caused by the cancer. That's why biliary obstruction is treated aggressively by drainage with stents, which can be placed endoscopically via the stomach and duodenum or through the skin directly into the main bile ducts in the liver. Infections need to be treated aggressively. Failure to do so can result in a patient dying even sooner than he had to.

Guess what? Gonzalez in essence admits that there were huge differences in supportive care between the two arms of the trial:

Of all the nutrition patients, only one - who ultimately survived 3.5 years - received anywhere near the level of intensive supportive care and encouragement given the chemotherapy patients. In this unique situation, the local doctors coordinated their treatment with me, realizing full well that he was sustaining a most unusual response. In no other case did the local doctors encourage aggressive intervention to keep the patients alive and also on the nutritional therapy.

Dr. Gonzalez just admitted a horrific lapse in clinical trial ethics. This lapse is not just his fault but the fault of each and every investigator in the trial. That both groups did not have access to the same level of palliative care is criminal--yes, criminal. The patients in the Gonzalez arm were condemned to suffer symptoms of progressive pancreatic cancer that were not treated with the latest and most aggressive palliative care: stents, antibiotics, laparoscopic gastrojejunostomy to bypas gastric outlet obstruction. If the investigators were unwilling or unable to make sure that patients in both arms had equal access to palliative care, then the trial should have been shut down until this glaring problem could be fixed. If the investigators couldn't find a way to fix this disparity between groups, then the trial should have been scrapped. The reason? Simple. Medical ethics demands it. For example, the Helsinki Declaration, the international agreement governing human subjects research, which states, "In medical research involving human subjects, the well-being of the individual research subject must take precedence over all other interests." The Belmont Report, the guiding document for medical research in the U.S. states: "In this document, beneficence is understood in a stronger sense, as an obligation. Two general rules have been formulated as complementary expressions of beneficent actions in this sense: (1) do not harm and (2) maximize possible benefits and minimize possible harms."

Gonzalez, while trying to cover his tail, just admitted that this trial failed to maximize possible benefits and minimize possible harms--and failed miserably.

In a way, it's fun to watch the flurry of charges and countercharges flying fast and furious back and forth between Dr. Chabot and Columbia University on the one side and Dr. Gonzalez on the other. However, we should never forget one thing, namely who suffered because of this trial. In the name of testing a ridiculously implausible "alternative medicine" therapy and an open-mindedness so wide that the investigators' brains fell completely out, patients with a terminal illness were denied therapy that would have palliated their suffering. As much schadenfreude as I feel for Gonzalez's discomfiture and frustration that Dr. Chabot managed to notch another publication in a high impact journal with apparently no harm to his career from his career, remember that it's not about Gonzalez or Chabot or any other investigator. It's about the patients with pancreatic cancer who were harmed in this study, which I view as the most unethical study done since the Tuskegee syphilis study. Never forget that as you're buried in self-serving twaddle.

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Oh, hell no. I wrote about your previous post in my journal a couple of days ago, because I work for a research foundation, and the ethics of studies are of particular interest to me. The idea that the nutritional subjects did not receive essential palliative medical care in this trial just makes me want to cry.

He made them suffer just to try and prove a point. If there was any such thing as hell, he should go there.

Hmmmm...my son just loves WWE wrestling, and I just love watching alties fight. What is the difference, one may ask?

There are two. The WWE is on TV on Monday night, and even they know it is a sham.

Note ot Orac: Chabot is getting his due for his stupidity in agreeing to host this study. He should have known better.

Regarding the denial of further care/palliative input to the "nutritional" arm of the trial.... Is this actually true, or just Gonzales' overactive imagination at work?

"However, Gonzalez makes a lot of hay observing that partway through the trial the chemotherapy regimen used in the chemotherapy arm changed."

But, the trial was of papaya juice against the best-of-care chemotherapy, wasn't it ?

Chemotherapy gets better al the time, based on studies and experimentation.
If half of the patients in the chemo arm received "old" chemo and the other half received the "new" chemo, it is safe to say that the Gonzalez juice failed against both.

It is not clear to me yet if the woo arm was identical to No Treatment, or was worse than no treatment.

I suppose it's possible that Gonzalez was so out of the loop that he was unaware that the paper was about to be published, but I tend to doubt it.

More than that, really. First, did he actually think that the results wouldn't be published? That would be pure unethical wrongheadedness there.

But even assuming he truly wasn't aware, so what? It's not like whether or not he was consulted has any bearing on the legitimacy of the results. Except to the extent that he believes the paper got things wrong, in which case he is free to make that argument (and in fact did).

Now, it would certainly be considered discourteous to publish without at least letting him know, and probably without soliciting his input on the paper (in physics, at least, and I doubt it would be different in medicine). But that doesn't make the results wrong.

This is quite a story. I don't pretend to understand all the politics but as a patient of Dr. Nick Gonzalez for many years, I know that I owe him my life. I have found him to be an honorable, honest man and a wonderful doctor. He has cured my cancer and hundreds of other patients like me.

Dr. Gonzalez clearly states to his prospective patients that his treatment ISN'T for everyone - you need to be able to eat and be mobile and swallow pills. I'm not a scientist but think it is quite reasonable that if any clinical trial were to test Gonzalez's treatment it should measure those with the SAME stage cancer getting chemo against those who actually were physically able to DO the Gonzalez treatment. Why measure against people who never swallowed a pill? What does that prove?

I learned long ago that there are some people who will never believe my treatment works but facts are stubborn things. I'm alive and Gonzalez is my hero.

Jenn

By Proud Gonzalez… (not verified) on 17 Sep 2009 #permalink

Since Gonzalez admits that he was the one who filed a complaint that led to the OHRP investigation and determination letters (which to me look like much ado about nothing), I donât think it is unreasonable for the others in the trial to keep him out of the loop in writing and submitting the paper. I donât doubt that he would have done whatever he could to thwart the process of publication (I see filing the complaint to have been done with that in mind). If he is an author, then he has to agree to everything that is in the paper. If he wasn't going to agree to any publication that wasn't a puff-piece for his protocol, then all he needs to do is withhold agreement and there is nothing the co-authors can do except write a paper without him.

@Proud Gonzalez Patient

I learned long ago that there are some people who will never believe my treatment works but facts are stubborn things.

Yes, yes they are.

So I'm sure that you wouldn't mind giving us your name and the name of some of the hundreds of others who were cured by the Gonzalez protocol. And I'm also sure you and some of these people would be willing to give us access to their medical records to see documented proof of a cure for pancreatic cancer. Since we're dealing with facts, we should put those facts out there for all to see, right?

Oh and by the way, why did you refer to Dr. Gonzalez's treatment as my treatment? Wouldn't that be his treatment since you're obviously not the doctor and didn't come up with the protocol?

Good morning, Orac. Unlike the previous commenter, I wouldn't know a stent from a stogie. All I know is that after reading this article, then Dr. Atwood's 5th part of his series and The Outcome, I am just astounded by the base, and quite obviously, uncaring actors pushing the snake oil arm of this charade. I can't believe it. I can't make my head wrap around the callous treatment of the subjects, already stricken with unimaginable fear, and pain, and...no, how could they do that to them? I do understand that perhaps Dr. Gonzalez truly felt that his protocols would prove to be superior than the standard treatment when they first learned they'd been approved/funded. Long before the stoppage, however, didn't he have enough evidence to know that his regimen was deeply flawed, and that the patients were suffering even more than untreated cases?

From his website, it looks as if Dr. Gonzalez has no immediate plans to discontinue his alternative-medicine pursuits, so I am very grateful that you, Dr. Atwood, and others I've read, are bringing these incredible charlatans out into the sunshine. What a shame and a thorough waste of talents and dedication that you are forced to wallow in this muck, rather than...any fucking thing.

Thank You

Thanks very much for the reference to Dan Burton.

That info will be available to voters in the primary next year. I just hope we can convince the (currently) three opponents not to fratricide.

fusilier
James 2:24

as I'd love to take him out to dinner and shake her hand

You know, in general I support proactive discouragement of gender stereotyping via mixing up which pronoun is used for the neuter tense, but I think you overdid it in this sentence. :p

Wait, so that doctor who did the study is not going to get punished? Because the only appropriate punishment I can think of is for him to lose his job forever, and for him to go to jail. This is messed up.

I agree totally with Jenn (6). As a longtime patient of Dr Gonzalez I have seen firsthand that he is incredibly honorable, dedicated and brilliant.

Your review of his response to the JCO article is so biased as to be almost a parady. You ignore many of the serious charges he levels. For example he says that 11 patients never even got to him or dropped out within a week after seeing him for the first time. How could they be counted as Gonzalez patients? Yet they were. Imagine what the survival rates would be if they were properly dropped from the analysis? And yes one does need to be motivated and reinforced to do the program - yet the oncologists they were seeing were actively discouraging them from continuing - and you applaud that?

The only valid conclusion from this whole sorry decade of a farce of a study is that the results prove nothing about the effectiveness of his program - only that it is impossible to fairly test a cancer therapy that goes against the grain of the medical establishment.

It seems to me that the only way that a reasonable evaluation of the Gonzalez program can occur is for a panel of unbiased researchers -if such a group can be found - to review all of his patient records say for the past 5- 10 years, and to interview patients where appropriate to confirm the information in the charts and publish the results.

However imperfect that approach might be, it is infinitely more legitimate than this study. It also avoids the thorny ethical and procedural issues that inevitably come up when testing a lifestyle therapy against a 'magic bullet' approach.

Yes - over the years as a Gonzalez patient, I have embraced the hard work I personally do every day to cure MY cancer as MY treatment...MY pills...MY special diet...MY detox programs...all saving MY life.

God bless Dr. Gonzalez

So, Jenn... How fun were the coffee enemas?

For example he says that 11 patients never even got to him or dropped out within a week after seeing him for the first time. How could they be counted as Gonzalez patients? Yet they were. Imagine what the survival rates would be if they were properly dropped from the analysis?

OK, let's imagine. Perhaps a bad outcome in those 11 patients could have obscured a marginal effect of the Gonzalez treatment. But Gonzalez advocates claim that his treatment cures cancer, not that it does just a little better than conventional chemotherapy. So even if some people failed to complete the therapy, those that did should still be alive at the end of the study. So how many Gonzalez patients were still alive after 40 months? None.

In fact, only two patients in the Gonzalez group managed to survive even as long as Patrick Swayze survived with chemotherapy. When the study ended at 40 months, one patient in the chemotherapy group was still alive. So drop as many as you want, there are still going to be more patients in the chemotherapy group surviving at the end of the study.

Jenn-

What sort of cancer were you diagnosed with and who diagnosed your cancer?

At this rate, Gonzalez will be basically claiming to "cure cancer" for actinic keratomas following excision with clear margins.

By D. C. Sessions (not verified) on 17 Sep 2009 #permalink

another thing, brought up in a conversation with my wife about Patrick Swayze.

Whenever someone falls for the latest quackaloon CAM bullshit, and (of course) it fails, the answer from the alties to the patient is always the same:

"It's YOUR fault, YOU didn't follow the treatment, YOU didn't believe hard enough, YOU didn't keep a positive enough attitude, you, you, you, YOU'

When my dad died of throat cancer, and various uncles and aunts, (that side of my family has QUITE the predilection), regardless of the specific words used, the answer was always the same:

"We failed. We did our best, but it wasn't good enough. We lost the battle, and your loved one died because we don't know enough yet, we aren't smart enough yet, we failed you."

There is a difference of attitude there that is significant, and a major reason why i despise CAM.

Hi happy Gonzalez customers. Two points:

1. Bernie Madoff was beloved.
2. Just because Dr. G didn't kill you doesn't mean he didn't kill others.

What I want to know is this: why didn't Dr. Gonzalez abandon his horrid protocol when the study met its stopping criteria FOUR FUCKING YEARS AGO!

Where are the cops? Why is Dr. Gonzalez not behind bars?

Chris, what is your hang up with enemas? You cant seem to let that go. From someone who has to get enemas all the time due to, lets just say colon issues, it is Not that big of a deal. Not my choice, but necessary. Let it go. Unless it is some fantasy of yours or something.

"continued health to you Jenn"

For example he says that 11 patients never even got to him or dropped out within a week after seeing him for the first time.

Assuming that that statement is accurate, it sounds like they used an intent to treat model, a fairly standard way of analyzing clinical trial results which avoids bias in cases of treatment which may be too toxic to be used by the average patient. Basically, the large number of early drop outs suggests that the therapy was poorly tolerated, possibly due to side effects, possibly due to the sheer complicatedness of the regimen.

Basically, the large number of early drop outs suggests that the therapy was poorly tolerated, possibly due to side effects, possibly due to the sheer complicatedness of the regimen.

Or maybe they quickly realized that Gonzalez was a raving loony.

By Militant Agnostic (not verified) on 17 Sep 2009 #permalink

This has been very informative, but there's one bit that leaves me confused and wondering if some piece of context has missed my attention.

It's the difference in palliative treatment. I understand calling this criminal; I'd have said the same, though without any expertise to make my opinion worth expressing. But Gonzales is complaining about this difference, not rationalizing it, so far as I could see. I followed the link and read the relevant bits on his website, or I think I did; and I see nothing that would incriminate him in this particular breach of ethics. Rather, he puts himself on the side of the angels, and I don't see what makes that claim false.

I presume I'm missing something, since Orac has looked at the case in detail and I haven't; but what is it?

By Porlock Junior (not verified) on 17 Sep 2009 #permalink

"I'm not a scientist but think it is quite reasonable that if any clinical trial were to test Gonzalez's treatment it should measure those with the SAME stage cancer getting chemo against those who actually were physically able to DO the Gonzalez treatment. "

Wow, that approach is quite brilliant! The patients come in sick, but able to follow the approach. Then aren't helped by his 'therapy', so they get sicker. At some point, they need to drop out because they are too sick to continue the 'therapy'. So they drop out and die, and that is never counted as a failure for that 'therapy', because they didn't die while taking it. Yay for intellectual dishonesty

"I'm not a scientist but think it is quite reasonable that if any clinical trial were to test Gonzalez's treatment it should measure those with the SAME stage cancer getting chemo against those who actually were physically able to DO the Gonzalez treatment. "

Wow, that approach is quite brilliant! The patients come in sick, but able to follow the approach. Then aren't helped by his 'therapy', so they get sicker. At some point, they need to drop out because they are too sick to continue the 'therapy'. So they drop out and die, and that is never counted as a failure for that 'therapy', because they didn't die while taking it. Yay for intellectual dishonesty

Porlock Junior : I presume I'm missing something, since Orac has looked at the case in detail and I haven't; but what is it?

The way I understood it, Orac isn't saying that Gonzalez denied palliative care to the nutrition arm patients, but that he (and all the others involved in the study) was responsible for them getting it. If he knew they weren't getting palliative care (and he admits he did) he should have done something about it. And from what he says, he didn't.

Still, I'm also curious about that claim. If someone has more details on it, or the take of one of the other doctors involved in the story...

By Caravelle (not verified) on 18 Sep 2009 #permalink

Apparently the only patients Gonzalez feels were "qualified" are those who are strong enough to live on his "therapy" for at least 12 months.

If they didn't survive long enough, they shouldn't have been in his branch of the study.

By Tsu Dho Nimh (not verified) on 18 Sep 2009 #permalink

I'm not a scientist but think it is quite reasonable that if any clinical trial were to test Gonzalez's treatment it should measure those with the SAME stage cancer getting chemo against those who actually were physically able to DO the Gonzalez treatment.

In fact, if you look at Table 1 of the paper, you will see that there was no statistical difference in the stage of cancer for the patients in the two arms of the trial. Dr. Gonzalez apparently agreed on the criteria for patient selection. What Gonzalez objected to was that there was no lead in "grace period" during which he could arbitrarily reject patients that he deemed to be too sick to receive his treatment, without them being counted as treatment failures. I have no doubt that it was clearly explained to Gonzalez why such a study design was impossible. Such a lead-in would have eliminated the sickest patients from the Gonzalez arm of the trial, but not from the chemotherapy arm of the trial, producing a bias that would strongly favor the Gonzalez arm. Of course, now that we can see the results, it is clear that the patients taking the Gonzalez therapy fared so dismally that it wouldn't have mattered. Despite Gonzalez's claims of long-term survival with his therapy, not a single patient in the Gonzalez arm survived for the full 40 month study period.

The only way such a lead-in design could have been done without bias would be to require every patient in both arms to start out on the Gonzalez therapy, and deny them all chemotherapy during the "lead-in" period (because otherwise, if things went poorly for the Gonzalez patients, he could blame it on the chemotherapy during the lead-in). Even considering the questionable ethics of that (which I suppose could be considered small potatoes given that virtually everything in the study was grossly unethical), they would never have been able to recruit patients for such a design--who in their right mind would agree to get an extremely unpleasant, arduous therapy for two weeks, then have it withdrawn so they don't even get to reap whatever doubtful benefits such therapy might provide, while meanwhile being denied the chemotherapeutic drugs that have been shown to reduce suffering and extend survival in pancreatic cancer?

I learned long ago that there are some people who will never believe my treatment works but facts are stubborn things. I'm alive and Gonzalez is my hero.

Notice the word "my treatment". Looks like Gonzalez wrote this himself. It's a shame there will be desperate people out there who will still see this SOB and give him there money to have them suffer.

First a quote from Schopenhaur on truth:
First it is ridiculed; next it is violently opposed; finally accepted as self-evident. I honestly and humbly ask why you are so vehemently opposed to Dr Nicholas Gonzolez's approach to cancer. It is not as if conventional medicine offers even an adequate solution. The cancer statistics despite all of the wonder drugs, remain horrific. It would seem to me that someone, such as yourself, who claims to be a caring and humble member of the medical profession, would at the very least be open minded regarding any and all treatments that are shown to have a positive impact on the destruction of cancer. Your ignorance on this matter is clearly evidenced by the fact that you completly ignore 20 years of Dr. Gonzolez's work in this area with a rather high success rate. You choose to focus on the failures of Dr. Gonzolez without equal and proper focus on the conventional medicine failures. How many of us, including yourself I am sure, have stood by and watched extreme suffering from the conventional treatments only to end in the inevitable death. Please spare me your uninformed blather on Dr. Gonzolez, while millions of people die each year from a set of treatments you seem to hold in such high regard. I am sorry, but you need to do some deeper due diligence on non-traditional treatments and then do a fair and balanced comparison with convential treatments. Why isn't there great outrage everytime a cancer patient dies after chemo or radiation. There seems to be a huge lack of criticism by people like yourself on the abject failure of conventional treatments. You and others like you should applaud and thank Dr. Gonzolez for his courageous pursuit of truth. It has given those of us who have dared to take the road less travelled an opportunity to be healed in a life giving environment. It is a "Choice", an informed "Choice" that each of us not only has the right but the responsibilty to make without the likes of people like you telling us that we should not have that right or choice. Instead of your vitriolic criticism you should be joining with Dr. Gonzolez in the pursuit of truth in whatever form it takes; truth that leads to the ultimate goal of preventing and curing cancer. I don't know what it would take for you to have an open mind, but I assure you that if by some miraculous change of heart, your entire life and world will be greatly blessed. CAM is a great way to go. A convergence of many modalities so that all possibilities can be considered. What better way to achieve the end goal than by working together toward that goal. So, put your own bias and predjudice aside and let your mind be open. Dr. Gonzolez is a man and a doctor of great integrity, courage and fortitude and I for one will be eternally greatful to his unwavering pursuit of Truth. Faye

First a quote from Schopenhaur on truth:
First it is ridiculed; next it is violently opposed; finally accepted as self-evident.

Unfortunately for you, Gonzalez's therapy has never made it past either the first or second of Schopehaur's steps. To do that, it needs evidence. Unfortunately for Gonzalez (and all the patients he's "treated" with his coffee enemas, "detox," and supplements), the evidence is all against him.

Which is why Gonzalez's therapy will never make it to the third step.

I honestly and humbly ask why you are so vehemently opposed to Dr Nicholas Gonzolez's approach to cancer.

Because he takes a lot of money from his patients, and puts them through hell, for NO BENEFIT.

It is not as if conventional medicine offers even an adequate solution. The cancer statistics despite all of the wonder drugs, remain horrific.

That's not evidence that Gonzalez's protocol works.

It would seem to me that someone, such as yourself, who claims to be a caring and humble member of the medical profession, would at the very least be open minded regarding any and all treatments that are shown to have a positive impact on the destruction of cancer.

And indeed he is. However, the Gonzalez protocol has not been so shown.

Your ignorance on this matter is clearly evidenced by the fact that you completly ignore 20 years of Dr. Gonzolez's work in this area with a rather high success rate.

Please provide the actual data showing "a rather high success rate." When it's been tested, the success rate was zero.

You choose to focus on the failures of Dr. Gonzolez without equal and proper focus on the conventional medicine failures. How many of us, including yourself I am sure, have stood by and watched extreme suffering from the conventional treatments only to end in the inevitable death. Please spare me your uninformed blather on Dr. Gonzolez, while millions of people die each year from a set of treatments you seem to hold in such high regard.

Beyond irrelevant. Medicine is not perfect, no. That doesn't give Gonzalez free license to torture his victims without any actual evidence to demonstrate it works!

I am sorry, but you need to do some deeper due diligence on non-traditional treatments and then do a fair and balanced comparison with convential treatments.

What, you mean like this one, where the unconventional treatment was objectively and conclusively shown to be grossly inferior?

Why isn't there great outrage everytime a cancer patient dies after chemo or radiation. There seems to be a huge lack of criticism by people like yourself on the abject failure of conventional treatments.

Because chemo and radiation actually work in some cases.

You and others like you should applaud and thank Dr. Gonzolez for his courageous pursuit of truth.

BS. Gonzalez has no interest whatsoever in truth, only in defrauding and torturing his victims.

It has given those of us who have dared to take the road less travelled an opportunity to be healed in a life giving environment. It is a "Choice", an informed "Choice" that each of us not only has the right but the responsibilty to make without the likes of people like you telling us that we should not have that right or choice.

Based on all the evidence, not a single person has ever been "healed" by Gonzalez. The choice you advocate is not that of patients to choose between therapies, but rather that of quacks to victimize the desperate.

Instead of your vitriolic criticism you should be joining with Dr. Gonzolez in the pursuit of truth in whatever form it takes; truth that leads to the ultimate goal of preventing and curing cancer.

Actually, Gonzalez should join with Orac in actually working towards effective treatments, instead of fleecing people with snake oil.

I don't know what it would take for you to have an open mind, but I assure you that if by some miraculous change of heart, your entire life and world will be greatly blessed. CAM is a great way to go. A convergence of many modalities so that all possibilities can be considered.

Completely useless, but a blessing and convergence anyway. *rolleyes*

What better way to achieve the end goal than by working together toward that goal. So, put your own bias and predjudice aside and let your mind be open. Dr. Gonzolez is a man and a doctor of great integrity, courage and fortitude and I for one will be eternally greatful to his unwavering pursuit of Truth.

I will say it again. The only Truth Gonzalez is interested in is written on green pieces of paper he can extract from the wallets of his victims without providing any actual treatment for it.

I think the Schopenhaur quote is gaining a foothold among woo believers as a replacement for that hoary old "They used to laugh at (place historical figure of science here), too!" At least in part because, while nobody (at least, not very many) has ever violently opposed Bozo the Clown, a great many have laughed at him.

By Richard Smith (not verified) on 21 Sep 2009 #permalink

Orac,

I vote for including the Gonzalez regimen study graph in any topic having anything remotely to do with Dr. Gonzalez. In fact, I vote for gratuitous over-use of that miserable graph of the dead and the dying.

GRAPH GRAPH GRAPH GRAPH GRAPH GOES HERE.

If "Dr. Gonzalez" googling always returns an image of that graph, some of his patients or their friends and family will see it. A few smart ones will understand it. Their "holy fuck" experience might mean that someone gets to live a few months more, and in less pain.

Your ignorance on this matter is clearly evidenced by the fact that you completly ignore 20 years of Dr. Gonzolez's work in this area with a rather high success rate.

Or so he claims to his customers. But when he had a chance to prove his treatment in a real, documented study, he couldn't save one person. Not even one.

You choose to focus on the failures of Dr. Gonzolez without equal and proper focus on the conventional medicine failures.

But in this study, Gonzalez's method was compared directly against conventional chemotherapy. And Gonzalez's patients died sooner and suffered more. You can be certain that if the chemotherapy patients had done that much worse than the Gonzalez patients, it would be front page news everywhere. But it was the other way around. So as limited as conventional therapy for pancreatic cancer may be, we now know that there is something worse--the Gonzalez treatment.

The post at #35 is a perfect example why CAM belief is indistinguishable from fundamentalist religion. Faye is just like a Young Earth Creationist who when faced with the fossil record, radioactive dating, ERVs and the silliness of Noah's Ark sticks their fingers in their ears and says "la la la I can't hear you".

Funny how with 20 years of claimed success, his therapy failed when it was tested under conditions where he couldn't cherry pick the outliers and hide the failures.

By Militant Agnostic (not verified) on 21 Sep 2009 #permalink

Excuse my school english but I want to comment this: isn't it a bit strange that Columbia university publishes a study with excellent results of gemcitabine for pancreas cancer just 5 years later? Their results, a median surviving of 14 months is far and far better then any other study with Gemcitabine for inoperable pancreas cancer. In the last study with gemcitabine and pancreas cancer for patients who were operated succesfully, so they had no cancer after their operation when the treatment started the median diseasefree survival was 11,4 months.

I think there is something very strange with the study of dr. Chabot and dr. Gonzalez. Monday the 19th. of october Larry King will interiew dr. Gonzalez and dr. Burzynski. I cann't wait for their answers.

Why has this guy not been shut down? My friend in England is refusing all conventional treatment due to the false hope this quack is giving her. Not only is it costing her everything she has, her cancer is progressing at a fast pace.A charlatan who benefits from peoples misery is my opinion. To watch you friend refuse chemo because he's sold her some dream is soul destroying..

By English Miss (not verified) on 15 Oct 2009 #permalink

I was working for the late Dr. William Donald Kelley at the International Health Insitute when Dr. Gonzales was there. Dr. Kelley gave Dr. Gonzalez full access to patients and their medical records. I suspicioned that Dr. Goode sent Dr. Gonzalez to see if he could gather enough evidence to discredit Dr. Kelley's research and work. Instead, Dr. Gonzalez was very impressed with what he found out, and now carries on with Dr. Kelley's work. Those of you on this board who have called Dr. Gonzalez a charlatan don't know what you're talking about. Einstein said,"Great Spirits have always encountered violent opposition from mediocre minds." Dr. Nicholas Gonzalez is a Great Spirit, as was Dr. Kelley.

By Dr. Jim Lane (not verified) on 19 Oct 2009 #permalink

If it helps, Dr. Jim Lane, I consider William Donald Kelley a charlatan, too. There's absolutely no good evidence that coffee enemas (or any of the other components of Kelley's or Gonzalez's treatment regimens) cure cancer.

By Credentialed (not verified) on 19 Oct 2009 #permalink

Dr. Lane,

How do you reconcile the results of this study - which show the Gonzalez/Kelley regimen was worse than "standard" therapy - with your apparent conviction that the Gonzalez/Kelley regimen "worked"?

Perhaps I am putting words in your mouth, but calling Drs. Gonzalez and Kelley "Great Spirits" seems to imply that their cancer treatment actually worked.

On the other hand, I suppose they could be "Great Spirits" and yet be utterly and completely wrong about their cancer treatment. Somehow, though, I find it hard to reconcile "Great Spirit" with "deceived hundred of people", even if they deceived themselves, too.

I'd love to hear your take on that.

Prometheus

By the way titmouse, here are a few quotes you might want to think about before you toss another F bomb. "Profanity is the weapon of the witless." "Profanity is the common crutch of the conversational cripple." "Profanity is the attempt of a lazy and feeble mind to express itself forcefully." "When a man uses profanity to support an argument, it indicates that either the man or the argument is weak---probably both."

By Dr. Jim Lane (not verified) on 19 Oct 2009 #permalink

Like I said Credentialled, you don't know what you're talking about.

Prometheus, I can attest to the fact, after having worked for Dr. Kelley for over two years, that the Kelley Program more often than not does indeed work. It will be very interesting if Dr. Gonzalez talks about the study tonight on the Larry King Show. Ask yourself this question, "Why would a licensed medical doctor subject himself or herself to ridicule and pursue a career in alternative medicine? It certainly isn't for the money.

By Dr. Jim Lane (not verified) on 19 Oct 2009 #permalink

One more thing. If the late actor Patrick Swayze had died while under the care of an alternative physician, such as Dr. Gonzalez, the press would have crucified the doctor. The headlines would have read, "Charlatan Doctor Murders Patrick Swayze With Coffee Enemas and Enzymes." Since he died as a result of being poisoned to death with extremely toxic chemotherapy drugs, that's OK. Most people treated for cancer with chemotherapy and radiation die as a direct result of therapy; not the cancer.

By Dr. Jim Lane (not verified) on 19 Oct 2009 #permalink

I just love me bunches of Mark Twain:

âUnder certain circumstances, profanity provides a relief denied even to prayer.â

and

"There are no people who are quite so vulgar as the over-refined."

However, to get back to JL's point:

Why would a licensed medical doctor subject himself or herself to ridicule and pursue a career in alternative medicine? It certainly isn't for the money.

You're joking, right? Snake oil can be sold for a lot of $$ to the desperate and dying.

Snake oil can indeed be sold for a lot of money to the desperate and dying ildi. Just ask any pharmaceutical company that compounds chemotherapy drugs.

By Dr. Jim lane (not verified) on 19 Oct 2009 #permalink

Dr. Lane, please answer Prometheus' question:

How do you reconcile the results of this study - which show the Gonzalez/Kelley regimen was worse than "standard" therapy - with your apparent conviction that the Gonzalez/Kelley regimen "worked"?

I know you said in reply to him "I can attest to the fact, ... that the Kelley Program more often than not does indeed work."

But that statement would have more weight if it actually included some real data. Is there some more coming? And is it being published in a real journal and not just at a public relations stint on Larry King? Is there some other data that is missing from the study that took several years to be published?

Most people treated for cancer with chemotherapy and radiation die as a direct result of therapy; not the cancer.

Bullshit. That's bullshit, pure and simple:

http://scienceblogs.com/insolence/2009/01/abusing_celebrities_with_canc…

http://scienceblogs.com/insolence/2009/09/a_religious_loon_cant_even_wa…

Show us the evidence that the Gonzalez therapy is anything other than quackery. This study demonstrates it about as unequivocally as it is possible for one study to do:

http://scienceblogs.com/insolence/2009/09/the_gonzalez_protocol_worse_t…

I just had to come back and see what kind of flak I was receiving as a result of my posts. I see that Orac is really upset. The proof is in the patients who are alive and well as the result of being treated with alternative therapies. It doesn't matter what I write here. We will just have to agree to disagree. If you are ever, God forbid, diagnosed with cancer Orac, you can choose whatever treatment you like. If you want to allow an oncologist to pump deadly poisons into your body, be my guest. But for me; I would choose to be treated by Dr. Gonzalez. You would think me a fool for that decision. And I would think you were a fool for yours.

Unfortunetly, Susanne Sommers, Dr. Gonzalez and Dr. Brzezinski were not on Larry King Live tonight. That segment has been rescheduled.

Chris is delusional to think that a fair and balanced report on a study of alternative cancer treatments would ever be printed in a main stream medical journal. When one knows that the pharmaceutical companies own the medical system in the US lock, stock and barrel, then one also knows; that ain't gonna happen. Follow the money.

By Dr. Jim Lane (not verified) on 19 Oct 2009 #permalink

"Dr." Lane:

Prometheus, I can attest to the fact, after having worked for Dr. Kelley for over two years, that the Kelley Program more often than not does indeed work.

I just did a PubMed search for "Lane cancer Kelley", there were no results. So, do you guys keep any records? Do you ever plan to publish? How do you expect any one to believe you if you hurl insults instead of evidence at us non-believers? Exactly what kind of doctor are you?

Credentialed:

There's absolutely no good evidence that coffee enemas (or any of the other components of Kelley's or Gonzalez's treatment regimens) cure cancer.

Since coffee delivered directly into the colon provides a caffeine punch, it both puts a strain on the liver and prevents sleep, which cannot be a good thing for any patient who is fighting an illness. I am beginning to think it is just a form of torture thought up by these guys. Either to be sadistic, or by placing some kind of additional burden on the patient/victim because they may believe the person brought on the cancer by some misdeed.

Of course, "Dr." Lane, you may persuade me that the coffee enema is a valid treatment and not a sadistic form of torture. What will persuade me is an explanation of the biological benefits, with accompanying verifiable scientific evidence.

When one knows that the pharmaceutical companies own the medical system in the US lock, stock and barrel, then one also knows; that ain't gonna happen. Follow the money.

Is JL a poe? It's really hard to tell sometimes.

Dr. Lane:

Show us the evidence!

That's all I've ever asked. No whining. No dodging. No anecdotes. Show us the evidence. As I've asked people such as you time and time again, where and who are all these people supposedly "saved" by Dr. Gonzalez? Data. That's what I'm looking for. Unfortunately for you, the data do not favor Gonzalez. His treatment is worse than useless.

@chris

Since coffee delivered directly into the colon provides a caffeine punch, it both puts a strain on the liver and prevents sleep, which cannot be a good thing for any patient who is fighting an illness. I am beginning to think it is just a form of torture thought up by these guys. Either to be sadistic, or by placing some kind of additional burden on the patient/victim because they may believe the person brought on the cancer by some misdeed.

I honestly sometimes wonder, who in the world ever came up with the idea that squirting COFFEE of all things up your hoo-ha was a good thing, and then, was able to convince someone else to do it!

Of all things, coffee? Seriously? I mean, these are the things that Bob Newhart standup routines are made of.

Of course with alt med cancer cures it is difficult to follow the money - those banks in the Cayman Islands are very tight lipped.

By Militant Agnostic (not verified) on 19 Oct 2009 #permalink

Wait, what? I am delusional for asking for evidence? Which is then followed by the Pharm Shill Gambit.

"Dr." Lane are for real? Do you really believe that papers that have been eviscerated on this blog due to very bad science were only published due to pharmaceutical company permission? Have you not heard of "Medical Hypothesis"? (okay, we would not accept it as viable proof from that rag, but it pretty much destroys your argument that only papers that meet Big Pharma's criteria get published)

Good grief, man... there has got to be enough money in Starbucks alone to publish a favorable paper on ingesting coffee backwards to show what benefit coffee enemas have. Where is the evidence that coffee enemas have any benefit? Show us the data!

And really, what kind of "doctor" are you?

The Failed War Against Cancer

Regarding cancer treatment, I sense a general feeling of frustration in the population. On a personal note, I can tell you that many people in my community are stricken and dying from cancer with little help from the mainstream medical system. The medical treatments with cytotoxic chemotherapy are cruel and barbaric treatments, serving to prolong agony and suffering for a few additional months. Friends and family stand by, helpessly, watching their loved one gradually succumb.

This dismal failure of conventional cancer treatment was recently highlighted by the rapid demise of Ed Kennedy with a fatal brain tumor, a glioblastoma. In spite of the best care available in the US, a high profile personality who had actually crafted health care legislation himself, suffered the same dismal 6-12 month survival as any one else.

The Time is Ripe for Health Reform

Perhaps Suzanne Somers also correctly reads this public frustration with cancer. and her new book is perfectly timed to take advantage of the changing tide of sentiment.

She trots out onto the stage three MD's working outside of the manstrem cancer paradigm with considerable success. Here they are:

Stanislaw R. Burzynski, M.D., Ph.D

Dr. Burzynsi isolated peptides which have anticancer activity, and infuses these back into the cancer patient. Results have been impresive for brain tumors, such as the one that killed Ed Kennedy, and another type of cancer called lymphomas.

James W. Forsythe M.D

Dr Forsythe has considerable success treating cancer with a nutritional supplement called Poly-MVA, invented by Merrill Garnett.

Nicholas Gonzalez MD

Dr Gonzalez treats cancer with a protocol deeloped by William Kelly based on the work of embryologist John Beard called the Trophoblast Theory of Cancer. Gonzalez uses high dose pancreatic enzymes along with a detailed nutritional supplement program. He has had considerable success with cancer remissions in advanced cases.

Rather than hailed has pioneers, all three have been hounded by regulatory agencies and persecuted for "thinking outside the box".

Jeffrey Dach MD
4700 Sheridan Suite T
Hollywood Fl 33021
954-983-1443

By Dr. Jim Lane (not verified) on 20 Oct 2009 #permalink

The medical treatments with cytotoxic chemotherapy are cruel and barbaric treatments, serving to prolong agony and suffering for a few additional months.

@Dr. Lane: I thought you said people die from chemotherapy and not cancer (and Orac rightly called your claim "bullshit.") So which is it, chemotherapy prolongs or shortens life?

I suppose you realize your arguments are based entirely on cherry-picked single-case anecdotes. Most people reading this will notice that weakness, FYI.

THIS DR KILLED MY GOOD FRIEND 20 YEARS AGO WITH THE COFFEE ENAMAS
HIS A HAS BEEN AND SHOULD BE DISBARED AND HELD FOPR MU8RDER
SUZANNE SOMMERS IS AN IDIOT
SHE JUST KEEPS WRITING BOOKS FOR NAUGHT
WHAT AN ASS
I CAN T BELIEVE HER LATEST CRAP MIS DIAGNOSED BY AMA DOCTORS WITH FULL BODY CANCER ANMD IT WAS ONLY A FUNGUS REALLY SHE IS TRULY IN LEFT FIELD
FRANK THOMPSON

By FRANK THOMPSON (not verified) on 20 Oct 2009 #permalink

Fail.

You have not answered any of the questions, and are just pulling out a bunch of quacks like they mean something (Burzynski!). Here is a hint: don't rely on researchers that announce to the press directly, especially the "brave maverick" type.

So exactly what is the reason for the coffee enemas other than a way to torture patients?

And, really, what kind of doctor are you?

At Doc Lane
from your own link;

"Prejudice against coffee enemas continues, however. Although this data was made available to Office of Technology Assessment it was largely ignored in their box on the procedure. They dismissively state "there is no scientific evidence to support the claim that coffee enemas detoxify the blood or liver."

Sounds good enough for me. I'll have my french roast in a cup please.

By Uncle Dave (not verified) on 20 Oct 2009 #permalink

A reference to Ralph Moss' website?
Yep, I'm convinced!

By T. Bruce McNeely (not verified) on 20 Oct 2009 #permalink

"Dr" Lane:

Major FAIL!

I asked for real evidence about how coffee enemas are beneficial and pull up the webpage of another quack:

To take a page from alties attacking big pharma: Remember that Ralph Moss makes lots of money selling woo; so take whatever he says with a big grain of salt. He really just wants to sell you his "newsletter" and get you to pay big bucks to see him speak.

Oh, yeah. They are just doing it for the love (of money!).

Now, exactly what kind of "doctor" are you?

Dr. Lane,

If I read your comments correctly, you claim that the "Gonzalez/Kelley" regimen works because..... well, because you have seen it work. Yet, this study (see above), which gives every advantage to the "Gonzalez/Kelley" regimen, has shown that it doesn't work and is, in fact, worse than the "standard" treatment.

You further argue that "mainstream medicine" is "of little help" based on the fact that Edward Kennedy died of glioblastoma in the same amount of time as a mere mortal, despite his wealth and social standing.

So, if I understand your reasoning, the fact that people still die in car crashes despite everything "mainstream engineering" has done means that modern automobiles are no safer than automobiles of the 1920's and 1930's?

And the fact that an actress thinks that Burzynski, Forsythe and Gonzalez are "pioneers" in cancer treatment is supposed to erase the fact that, of the three, only one has had their "treatment" tested (and it failed miserably, I might add)?

Again, I ask you to explain how you can see the "Gonzalez/Kelley" regimen as successful when it has just been shown to be a spectacular failure? Please don't try to distract me with tales of how "people are still dying of cancer", because the people in the "Gonzalez" arm of this study died even faster than those who received "conventional" chemotherapy. And don't try to persuade me with testimonials from actresses - they don't persuade.

You may be so deep in this.....stuff that you can't fathom that it might not work (hint: it doesn't), but your beliefs aren't convincing me. If you have any data that supports your position, please let me know.

Eagerly awaiting data,

Prometheus

I know you said in reply to him "I can attest to the fact, ... that the Kelley Program more often than not does indeed work."

But that statement would have more weight if it actually included some real data.

Data? We ain't got no data! We don't need no stinkin' data!
What's good enough for Dr. Jay is good enough for me!!!

By T.Bruce McNeely (not verified) on 20 Oct 2009 #permalink

How about a fair and balanced discussion folks? You keep referencing that you want scientific data and you have declared Gonzales's work to be ineffective. I read the rebuttal on Gonzales's website to the JCO article on the clincial trial. Did you?

Links below:

http://www.dr-gonzalez.com/jco_rebuttal.htm

http://www.dr-gonzalez.com/nci_nccam_timeline.htm

Seems clear to me that the only true conclusion is that the trial was a total mess. Not at all hard to believe that it was sabatoged. So how can you believe any of the so called "conclusions"? The trial appears to have proved one thing - alternative medicine cannot get a fair trial in the US.

Jill, will you please explain to me the biological benefits of the coffee enemas?

Since the coffee is delivered straight to where it is absorbed it keeps the patient from getting very needed rest, and puts a strain on the liver. How is that not the very definition of torturing the patient?

I want you to explain the biological benefits versus the issue of keeping the patient from resting, in your own words, not to link to random websites. I also want real medical evidence cited, like actual papers: cite the journal, title, author and date.

Thank you.

Cripes, Jill, did you even read your first link!? It says:

Like coffee consumed orally, coffee enemas can be stimulating and result in caffeine dependence.

How is a cancer patient supposed to get very needed rest if they are doped up on caffeine! Making a patient caffeine dependent sounds more like torture than useful therapy.

Then it continues:

Although infrequent, complications may include perforation of the wall of the intestines, electrolyte imbalance, heart failure and death. The risk of side effects increases if coffee enemas are combined with fasting.

Now when you combine the fact that protocol requires multiple enemas per day, the "infrequent" has a better chance of actually happening.

Now really, explain the benefits versus the risks. Give some good documentation (actual medical literature) that compares them.

And you second is a "how-to", not an academic explanation of the biological benefit. Also, the job of the liver is to remove toxins... caffeine is one of the toxins that your liver helps remove. So it does not detoxify the liver, it makes your liver work harder! You need to learn some basic biology.

What a silly, biased article. More importantly I would consider it a dangerous and misinformed article that may put people off a treatment that could save their lives. I am a patient of Dr.Gonzalez and I owe my life to him. His protocol works and for those of you who want the science behind it..... go look it up like I did. I spent a year researching both conventional and alternative cancer treatments (whilst on chemo, 3 operations and radiation, which, by the way, didn't work), this one made the most sense scientifically and lo and behold it did the job. I felt the difference nearly immediately when starting.
I'm not going to argue with the nonsense written above by people who really haven't a clue what they are talking about, it's a waste of my time, but I would say to all the critics of Dr.Gonzalez that whilst an open, questioning mind is a healthy thing and helps us to learn and grow, the rabid aggression demonstrated by some posters is of no benefit to anyone.
I have found Dr.Gonzalez to be, in contrast to my three oncologists, a caring, involved, and knowledgeable man who knows his conventional and alternative facts inside and out. Oncology is a horrible failure. You are mislead, tortured, and then abandoned when it fails.... as it mostly does. Dr.Gonzalez stays available for his patients who, by the way, are mostly end stage cancer patients, there as a last resort. He is far cheaper than conventional treatments and believe me, the pancreatic enzyme/healthy diet/coffee enema route is a much, much gentler one than chemo, radiation etc. as well as being more successful. I've done both so I know.
Try it and see the difference it will make to your health, and to your life. that's the best way to test the Kelley/Gonzalez protocol, away from all the manipulations and carry-on of medical politics, and in the privacy of your own home. Do it correctly and you will be amazed. Then, and only then will you be fully qualified to make an informed judgement.

What a silly, biased article. More importantly I would consider it a dangerous and misinformed article that may put people off a treatment that could save their lives. I am a patient of Dr.Gonzalez and I owe my life to him. His protocol works and for those of you who want the science behind it..... go look it up like I did.

No, his protocol does not work. This study puts the final nail in that coffin. On average, patients undergoing the Gonzalez protocol did much worse than patients undergoing standard chemotherapy:

http://scienceblogs.com/insolence/2009/09/the_gonzalez_protocol_worse_t…

Given that this was a trial in pancreatic cancer patients, that's really saying something.

"No, his protocol does not work. This study puts the final nail in that coffin."

Just read this whole thread. What strikes me is that at the root of the disagreement there seem to be two points of view:
1) Dr. Gonzalez is a quack and everything he does is meritless (or worse); and
2) Dr. Gonzalez' methods work, and I (Jenn, Maria, etc.)am living proof.

The first point of view is based on the trial being discussed; the second on actual experience of patients of Dr. Gonzalez or people with direct experience of traditional cancer treatments.

IF there were flaws in the study, which evidently there were, it would seem another, better trial is in order before we call all of Dr. Gonzalez' patients liars?

Another thought...Wouldn't we all agree that each mature human being has the right to choose the manner in which to heal their own body, based on information they have gathered from whatever their sources?

Lastly, we have recently learned that for many years Dr. Scott Reuben has been fabricating "studies" (dozens of them) and then publishing them in legitimate medical journals for money paid to him by pharmaceutical companies (Pfizer in particular). It's well documented that this goes on all the time, so it's not surprising that many people have trouble trusting the medical/pharmaceutical industry and the often complicit FDA.

Opinion is always based on point of view, and point of view is always limited by an individual's belief, conditioning and/or experience. In the final analysis most of us believe what we want to believe, because it's comfortable, and we don't like being wrong.

It's depressing that the Gonzalez trial went so drastically wrong, even to the point where his worst critics begin to doubt the published results. "why did they die so quickly". But I get the impression that it happens all the time. Deadly drugs come up smelling like roses and harmless vitamins are accused of causing cancer. You have to look at these studies with a critical eye and when they appear to be garbage, hope that they are repeated with better attention to detail.

Dr. Lane, it is good to hear from somebody who knew Dr. Kelly and Jenn, how nice to hear from a fellow Gonzalez patient. Sevika, thank you for your calm and intelligent comments.

As for the rest of you, what do you know about the program? The moderate vegetarian diet is very like the much touted Mediterranean diet, minus the wine. It's satisfying and delicious ( of course you have to shop and cook and maybe that is the torture of which you speak). When the cardiologist says "no eggs, no meat, no cream, no butter, no coffee, no booze until death, do all of you whine about torture and why not? When the oncologist leaves you impotent, sterile, incontinent or dead, do you fuss about torture? Of course not, it was in the fine print.

The pills are a nuisance, but the side effects of the program are great! No colds, no more need for asthma or arthritis meds, the list can be long.

Now back to the enemas that bother so many of you people. They are not uncomfortable, we are not talking gallons here and no ice cubes are involved. The equipment is standard medical stuff. For anyone bothered by IBS concerns, they provide a layer of control. As for curing cancer, nobody ever said they did. Dr. Gonzalez never uses the word cure. He warns that once the body learns how to make a tumor, you must always be on guard, whatever treatment you follow.

Carol:

Now back to the enemas that bother so many of you people. They are not uncomfortable, we are not talking gallons here and no ice cubes are involved.

What they are doing is supplying the bloodstream with caffeine directly. This makes sure that the patient does not get needed rest, and puts a strain on the liver. This was mentioned several times up thread. How did you miss that?

Of course, if you have real medical evidence that coffee enemas are beneficial, please present (but look up thread for examples of what not to use as real evidence). You may also do the same for the 140 daily supplements.

Chris:

"What they are doing is supplying the bloodstream with caffeine directly...and puts a strain on the liver."

No, not true.

When done correctly (and this is not difficult), the caffeine in the coffee enema is preferentially absorbed into the enterohepatic circulation system*, and goes directly to the liver where it becomes a very strong detoxicant. (*The enterohepatic system is the special circulation system between the sigmoid colon, or last portion of the colon before the rectum, and the liver.) The coffee does NOT go into the systemic circulation unless the enema procedure is done improperly.

It is the liver and small bowel that neutralize the most common tissue toxins: polyamines, ammonia, toxic-bound nitrogen and electrophiles. These detoxification systems are enhanced by the coffee enema. Physiological Chemistry and Physics has stated that "caffeine enemas cause dilation of bile ducts, which facilitates excretion of toxic cancer breakdown products by the liver and dialysis of toxic products across the colonic wall." Many people have noted the paradoxical calming effect of coffee enemas.

In addition to increased detoxification, other compounds in the coffee enema (theophylline and theobromine) dilate blood vessels and counter inflammation of the gut. Finally, the fluid of the enema stimulates peristalsis and the removal of diluted toxic bile - from the duodenum and out through the rectum.

Dr. Lee W. Wattenberg, MD (Univ. of Minnesota/NCI-Designated Masonic Cancer Center) was able to show that substances found in coffee - kahweol and cafestol palmitate - promote the activity of a key enzyme system, glutathione S-transferase. This enzyme is responsible for neutralizing free radicals, harmful chemicals now commonly implicated in the initiation of cancer and needed for detoxification. Consuming coffee orally does not produce the benefits experienced when it is taken as an enema.

Note: Glutathione is a natural sulfur-bearing peptide formed from the linking of three amino acids: glutamic acid, cysteine and glycine. Glutathione acts as an antioxidant and detoxicant and is involved with the selenium-containing enzyme glutathione peroxidase. Glutathione is also involved in amino acid transport across cell membranes and is a powerful free radical scavenger and antioxidant that removes toxic substances from the body.

Other mechanics - The coffee enema causes the liver to produce more bile (which contains processed toxins) and moves bile out towards the small intestine for elimination. This frees up the liver to process more incoming toxic materials that have accumulated in the organs, tissues and bloodstream. In other words, a coffee enema speeds up the detoxification process and minimizes the backlog of yet-to-be-detoxified substances.

Summary: There is a lot of good information out there to suggest coffee enemas may be excellent medicine for some people. One thing is certain...finding greater truth requires an open mind and a willingness to question not only authority, but our own belief system.

OK. Now I KNOW that this protocol is nonsense. There is a "...enterohepatic system is the special circulation system between the sigmoid colon, or last portion of the colon before the rectum, and the liver.) The coffee does NOT go into the systemic circulation unless the enema procedure is done improperly."????? There is NO special circulation loop that does not involve the systemic circulation. How crazy is this? All blood vessels are connected in the circulatory system. Good grief, people, read a basic anatomy book! Get the Gray's Anatomy coloring book and color the circulatory system. SEE what your body looks like instead of just blindly following some quack stupidity.

(Oh...and did anyone notice that Maria underwent TRADITIONAL treatment before going to Gonzalez? Wanna bet she was in remission before she went to the quacks?)

sevika:

Another thought...Wouldn't we all agree that each mature human being has the right to choose the manner in which to heal their own body, based on information they have gathered from whatever their sources?

Absolutely! Every competent adult human has the right to choose the manner of healing -- and even to choose not to heal. (My grandfather chose not to receive treatment for what he felt was very likely pancreatic cancer. He was 91, had lived a full life, and preferred to be able to concentrate on staying comfortable. I'm not so sure I would've made the same choice, but it was his choice to make, and he made it with a clear head.)

However, I do not believe that it follows that every adult human being has the right to offer whatever damn fool treatment they think up without first quantifying safety and efficacy so that patients can really know just what it is they are choosing. The Gonazalez Protocol currently has sporadic anecdotal evidence going for it and a major clinical trial going against it. Perhaps it would be worth additional study, assuming you can find an ethics panel willing to sign off on it. But it is definitely not "ready for prime time". Doctors should not be representing it as proven safe and effective. That is what is commonly referred to as "lying". Now, a patient who truly understands the low quality of evidence and the risks involved in the Gonzalez Protocol is certainly welcome to try it. But doctors who conceal that information from patients (whether because they refuse to look at it or because they don't care) are doing a grave disservice to their patients, IMHO.

Those of you who feel that Gonzalez helped you -- more power to you. I'm glad you feel well. I'm not going to use your experience to guide my own decisions, however, because I see too many reasons to doubt that your experience will apply to myself.

By Calli Arcale (not verified) on 22 Feb 2010 #permalink

Hello MI Dawn,

You've misinterpreted. I didn't say the enterohepatic circulation system doesn't involve the systemic circulation; that should be obvious. I think you'll agree, however, that different systems within the body have different specific functions. Gray's Anatomy does not go into physiological depth; one has to look elsewhere for the whole physiological picture.

By the way, I'm not suggesting that anyone out there try the enema, or follow Dr. Gonzalez' protocol, or believe what anyone else says about anything. This is just a discussion. However, since my father was permanently cured of osteosarcoma in what is called 'spontaneous remission' (he lived 54 more years), my mind may be more open than some regarding extraordinary pathways to healing. I do think it's interesting that there is so much anger surrounding this thread.

Hello Calli:

With respect, there have been many "damn fool treatments" that have later turned out to be effective, and it's been shown time and again that the medical 'establishment' has prescribed drugs with little or no long term definitive (independent) testing, with deleterious and sometimes fatal results. (Enovid and Gardasil come to mind.) No one yet is curbing that appetite for profits.

Some of us have had long experience with conventional medicine, with mixed results. What I have learned is that natural plant substances (from which most, if not all synthetic drugs are derived) can be extremely effective in reversing a given disease process, and they are often far kinder to the body, which this body appreciates.

Has anyone else read Michael Gearin-Tosh's book, "Living Proof"?

Be well, all.

How about providing real evidence, something we can find in our local medical school library. PubMed links would be fine.

Also, do try to get a handle on basic anatomy. What does the liver do? Why would it need detoxing? Do not reply with books we are supposed to read (by an English professor!), but the journal, title, date and author of the scientific paper that shows the evidence of your claims.

By the way, Michael Gearin-Tosh died when he was 65. He is hardly "Living Proof."

Chris,

1) I'm not attempting to prove anything. If by "real evidence" you mean peer reviewed trials, we both know there won't be much on this yet. Did you by any chance look up Dr. Lee Wattenberg?
2) Medical school libraries won't contain anything of substance in the alternative realm.
3) Don't remember saying the liver needed detoxing; only that toxins go to the liver FOR detoxification.
4) Didn't suggest anyone should read Gearin-Tosh; it was just a question. He lived ten years longer than the docs said he could with multiple myeloma, and his story is both compelling and well written.
5) I've made no claims whatsoever. I'm always interested in new ways of thinking and new modalities of healing. What I'm not at all interested in is an argument. Life's too short.

sevika:

Medical school libraries won't contain anything of substance in the alternative realm.

Do you know that when something is "alternative" is found to work gets called? Medicine.

Still don't see any evidence that coffee enemas do anything. Sending us off to read random books does not count. Excuses don't count either.

Chris:

You'll never find your evidence. Progress or improvements can always be attributed to something else, some other variable in the treatment. Spontaneous remissions have not been explained scientifically, yet they occur. It's unfortunate that you value being right more than you value discourse.

Good luck to everyone out there.

Gonzalez isn't the only one that rebutted the findings, the National Cancer Institute (who co-sponsored the study) regards the Journal of Clinical Oncology article as unwarranted and summarized the findings as "limited and inconclusive" because of the botched and unscientific methods used by the folks at New York Presbyterian University of Columbia.

Hmmm, pity poor Orac who can't get his facts straight and has no clue of what he writes.

OMG the ignorance on this board is bliss. Most that criticize Gonzales obviously have no medical, scientific, or research background (and one seems to have a fetish about enemas - it's alright you can go to the bathroom and get your jollies now). This is a great group of pots to be calling the kettle black. I'm a Clinical Chemist and Electrical Engineer by trade, certified by the American Association of Clinical Chemists and have 25+ years of experience; have been involved in research and worked for Syntex Pharma. I can tell you unequivocally that these studies are rarely true to being double blind or unbiased. As for those of you that doubt me, I'd be happy to give my name and credentials (when you give me yours and prove to me that your qualified of a worthy debate for me to permit that invasion of privacy).

BTW, if the chemo group refused to take their chemo would you be so anxious to dismiss the chemo as quackery?

MikeA:

the National Cancer Institute (who co-sponsored the study) regards the Journal of Clinical Oncology article as unwarranted and summarized the findings as "limited and inconclusive" because of the botched and unscientific methods used by the folks at New York Presbyterian University of Columbia.

Reference? Surely in the eight months since Orac (a surgical oncologist) wrote this this report and the two months since the last comment it would be publicly available.

Also, do a check on your reading comprehension. I am questioning the scientific reason for a coffee enemas. I think the whole premise of keeping a patient wired and awake, while putting more strain on the liver to be torture, not therapy.

Short version: coffee enemas = torture

Now if you have any real verifiable scientific evidence to support your claims, please provide them.

the National Cancer Institute (who co-sponsored the study) regards the Journal of Clinical Oncology article as unwarranted and summarized the findings as "limited and inconclusive" because of the botched and unscientific methods used by the folks at New York Presbyterian University of Columbia.

The bolded part is Mike's "interpretation" of what the NCI said.

Coffee enemas were used in the 1940's to pacify mental patients. I know a couple retired practioners who prescribed the therapy. I studied the practice years ago and found serum levels of caffeine from rectal administration of coffee are about as high as oral. There was a paradox comparing the effects though. Rectal administration did relax the subject and even promoted sleep.

By Dave Crawford (not verified) on 06 Jun 2010 #permalink

Lots of stupid comments here.
I met with Dr. Gonzalez to discuss my cancer situation.
I found him to be a very decent, very intelligent guy.
In the end, I decided to do nothing but do the best I possibly could for my body..no drugs, no Gonzalez regimen.
I've been fine for almost 3 years.
Gonzalez graduated from Cornell and then did an internship at Vanderbilt.
I think that it is darn incredible to do what he did from there.
99%+ of the medical school graduates would go the conventional route and make great money at it.
He chose to take a risk on something very unconventional...to make a lot more money??? I doubt it.
If he is so terrible, then why has he not been shut down?
He doesn't say that his program cures all cancers. He doesn't guarantee anything. But I've spoken to two of his patients that swear by him and I didn't speak to them via any contact with him. His program is intense, but it works for many people. Ask Ralph Moss, who is very open to ALL cancer treatments that seem to help. When I spoke to him, he suggested that I go with a vaccine at a major cancer center to prevent a recurrence...hardly just an alternative medicine advocate. PEOPLE, DO YOUR HOMEWORK. DON'T JUST SPIT OUT GARBAGE BECAUSE YOU ARE A BELIEVER OR A SKEPTIC.
1) The trial above was very flawed.
2) Gonzalez has had lots of success stories...if he didn't, people would be blogging in droves on behalf of their loved ones that died while on his regimen.
3) The Gonzalez regimen requires people with sufficient mental and physical strength as it is very intense.
4) I would love to see a group that were kept alive by Gonzalez and others come forward with their records, etc., have their results verified, and show the world that there is indeed a place for good alternative medicine.
5) In the end, we want good alternative medicine MDs like Gonzalez, and the fraudelent ones to be put in jail.

Jake;

It's good that you're still here, may things continue to go well for you.

1) Please describe the flaws you see in the study, preferably with support from credible sources.
3) So if the regimen doesn't work, the patient was weak (IOW, it's their fault)?
4) Yes, that would be great to see. Amazing that Dr. Gonzalez can't produce such people, isn't it?
5) Be careful what you ask for, since the evidence strongly disagrees with your opinion of Dr. Gonzalez.

By Scottynuke (not verified) on 10 Jun 2010 #permalink

In the end, I decided to do nothing but do the best I possibly could for my body..no drugs, no Gonzalez regimen.

I've been fine for almost 3 years.

Out of curiosity, what kind of cancer do you have. What's the stage? How was it diagnosed?

3) The Gonzalez regimen requires people with sufficient mental and physical strength as it is very intense.

In other words, you're admitting, as I pointed out in some of my posts on the Gonzalez regimen, that the appearance of better survival was all selection bias. Only those in better shape could make it through the regimen, people, who, by the way, would be more likely to do better no matter what. As for the rest, I guess they're just S.O.L.

Hi scottynuke.
1) Please describe the flaws you see in the study, preferably with support from credible sources.

I recall reading that the NCI admitted that the trial was flawed but I'm sorry that I can't locate the website that I saw this on. I'll keep looking. TBD

3) So if the regimen doesn't work, the patient was weak (IOW, it's their fault)?

Scotty, I'm an electrical engineer. I and most of my peers are very honest as our testing results don't lie. The regimen was supposed to perform better than the chemotherapy. The patients in the "enzyme arm" need to be strong enough to swallow 200 pills a day and do all of the other things that this regimen calls for every single day. Those in the "chemo arm" should be in the same condition for this to be a fair comparison.

4) Yes, that would be great to see. Amazing that Dr. Gonzalez can't produce such people, isn't it?

He has produced a list of patients and records for the NCI or NIH to see. This is one of the main reasons why this study was funded. Due to patient confidentiality, he can't produce a list to show the world on his own. He has to have the cooperation of the patients to do this.

5) Be careful what you ask for, since the evidence strongly disagrees with your opinion of Dr. Gonzalez.

I've spoken with 2 people that have been on his regimen and both have nothing but good to say about him. I've spoken to Ralph Moss about him and he admitted that his records show exceptional success with cancer treatment.

Hi Orac,

Just wanted to answer you...6 months later!!

Out of curiosity, what kind of cancer do you have. What's the stage? How was it diagnosed?

Melanoma, stage 3 (lymph node involvement). Diagnosed by NYU physician with a needle biopsy and then by Sloan Kettering pathologists after the lymph node and 20 others were removed in surgery.

3) The Gonzalez regimen requires people with sufficient mental and physical strength as it is very intense.
In other words, you're admitting, as I pointed out in some of my posts on the Gonzalez regimen, that the appearance of better survival was all selection bias. Only those in better shape could make it through the regimen, people, who, by the way, would be more likely to do better no matter what. As for the rest, I guess they're just S.O.L.

He doesn't take on everyone because he knows that he can't help many of them...that they are too far gone for his help. They have to be strong enough mentally and physically to follow the program every single day (I would think that missing a coffee enema once a month and a few pills occasionally would not matter!). The program takes a lot of effort for sure. I did not want to do it because I was hoping to be part of an NYU vaccine trial which would be much less effort on my part. I did not want to spend so much of my day doing this protocol, waking up at 4 am to take pills, etc. However, I was following a very strict diet (vegetables, grains, blueberries, free range chicken, wild salmon, etc., etc. I never did the NYU trial because at that time I was 2 years + NED and my oncologist kind of discouraged me because I was doing well and "why mess with the immune system as it is". If I every became stage IV, I think that I would follow the gonzalez regime.
Check out his website. Read about the testimonials from some bigshots at some large companies. You know that he can't lie about these testamonials as he would be sued.
Also, ask yourself, why hasn't he been shut down?
And ask yourself, why did he follow this route? He was a Cornell med. school graduate, internship at Vanderbilt, etc. To make a fortune doing this? I don't think so. There was no guarantee of many patients.
Finally, in today's day where information sharing is incredible, if he was so bad, where are the bloggers trashing him?

Melanoma, stage 3 (lymph node involvement). Diagnosed by NYU physician with a needle biopsy and then by Sloan Kettering pathologists after the lymph node and 20 others were removed in surgery.

Congratuations! A fellow surgeon of mine (a surgical oncologist) is the one responsible for how well you're doing. Surgery is still the most effective treatment for melanoma. Occasionally, even stage IV melanoma can be cured with surgery, as long as it can be removed completely.

Hi Orac.
Do you know that to be the case? (that the surgeon I had is responsible for me doing well?)
Was it the surgery?
Was it the radiation?
Was it my belief in God?
Was it my diet?
Was it reiki, massage?
Was it all of the above.
I'll never know and neither will you.
I'm just thankful that I had Dr. Krauss do the surgery, Dr. Pavlick as my oncologist, an uncle that is a capuchin priest, a loving family, and the willingness to change my lifestyle.
So you are a surgeon. What kind of surgeon?
Do you ever recommend that patients change their lifestyle if they have a serious health issue as Dr. Hiromi Shinya, author of "The Enzyme Factor" does? If not, you are not doing right by your patients. If our immune system is key in fighting off disease, etc., then why don't we optimize it? I could go on and on. Some of the studies that I see done are a joke. Drinking wine is good for you. Did they examine 10,000 subjects that were all pretty much doing the same thing and had pretty much the same genes and see how the group drinking wine did compared to those that didn't? NO. Like my internist said...is it the french wine, the french diet, the frence lifestyle, etc.?

Jake: "So you are a surgeon. What kind of surgeon?"

See the most recent posts on Robert O. Young and the death of Kim Tinkham. You might get a hint.

Jake asks what cured his cancer:
Was it the surgery?
Was it the radiation?

Undoubtedly those two things. (The likelihood of spontaneous recovery is too small to contemplate.)

Jake also asks:
Was it my belief in God?
Was it my diet?
Was it reiki, massage?

Those things are irrelevant. (As long as the diet is sufficiently nutritious.)

We (especially Orac) know a lot more than you realize.

To Chris:
I'll wait for Orac to tell me specifically what kind of surgeon he or she is.

Do you know that to be the case? (that the surgeon I had is responsible for me doing well?)
Was it the surgery?
Was it the radiation?
Was it my belief in God?
Was it my diet?
Was it reiki, massage?
Was it all of the above.
I'll never know and neither will you.

Surgery - proven to be effective
Radiation - proven to be effective
Belief in God - no proof of effectiveness, may help you feel better
Diet - no proof of effectiveness, may help health in general
Reiki and massage - no proof of effectiveness, may help you feel better

I may not know for sure, but I have a pretty good idea.

By T. Bruce McNeely (not verified) on 14 Dec 2010 #permalink

I'll wait for Orac to tell me specifically what kind of surgeon he or she is.

Oncologist. It says so repeatedly on this page, and on the article Chris was referencing. This is why nobody takes you seriously: You don't even try to search for answers, you just want them handed to you.

By Gray Falcon (not verified) on 14 Dec 2010 #permalink

Jake: "I'll wait for Orac to tell me specifically what kind of surgeon he or she is."

Translation: "I'm too lazy to read a few pages and so presumptuous that I think Orac really should jump at my request".

Just because Jake is a lazy idiot and a jerk to boot, there's no reason for him not to know that Orac is a breast cancer surgeon and researcher.

There, Jake, you didn't even have to do any work to get the answer.

However, nothing says you have to believe any of us. If it wasn't so difficult for you to do, I'd suggest you go over to Science-Based Medicine (Sciencebasedmedicine.org) where Orac blogs under his real name so you can read all about him. However, I know for jerks and trolls, performing research is very difficult, so I won't require that kind of strenuous activity.

@Jake

I'll wait for Orac to tell me specifically what kind of surgeon he or she is.

Hmm...you may be able to infer what you are looking for if you read the info about Orac. There's a link in the brief bio at the upper left of the page. You may also get something from the "Science and Surgery" sites he links to at left. All of that stuff may give you some idea, but I'm guessing you'll just ignore that and continue to "wait for Orac".

Was it all of the above. I'll never know and neither will you.

@Jake: Strictly speaking, no, you won't. But there's something called evidence, and something called statistics, which tell us that surgery is almost certainly what helped you, while Reiki and prayer did nothing.

The scientific method, which relies on evidence, and mathematical tools like statistics, evidently works. Magical thinking does not. You get that?

Hi JJM.
I must respectfully disagree with a few things in your post.

You said in your post:

"Jake asks what cured his cancer:
Was it the surgery?
Was it the radiation?
Undoubtedly those two things. (The likelihood of spontaneous recovery is too small to contemplate.)"

I (Jake) never mentioned that my cancer was cured.
There could still be melanoma cells in my body, but, of course, I hope not.

As to why I haven't had a recurrence over these past 3 years?

Surgery and radiation? Undoubtedly you say? How do you know that? No one on this earth does.
Yes the surgery removed the cancerous lymph node and I thank Dr. Kraus for that.
But regarding the reason for no recurrences in 3 years:
Nobody KNOWS the answer.

You also say:

"Jake also asks:
Was it my belief in God?
Was it my diet?
Was it reiki, massage?
Those things are irrelevant. (As long as the diet is sufficiently nutritious.)"

Irrelevant? I guess you don't believe in God and his miracles? That's fine...your choice.
As for diet...I suggest reading "The Enzyme Factor" by Hiromi Shinya, MD, inventor or co-inventor of the colonoscope and a well known G.I. doctor.
As for reiki? I can only go by someone that I trust very very much for how much power it has.
Massage? Keeping stress down...aiding the immune system, no?

Conventional medicine practitioners need to think outside their box and embrace people like Dr. Shinya and Dr. Caldwell Esselstyn (Cleveland Clinic...for his work on diet and reversal of heart disease...his colleagues called him Dr. Sprouts!!) who are MDs and realize the importance of diet. They also should look more into what another very bright MD, Nicholas Gonzalez is doing and fairly investigate whether pig pancreatic enzymes can be helpful in destroying cancerous tumors. From there, they can look at the other elements of his "system", instead of just waving it off as quackery. Do we want to have the best system for "limiting" cancer or do we just want to stick with surgery, radiation, and drugs and nothing else? The medical profession should be far more thorough.

Jake:

Surgery and radiation? Undoubtedly you say? How do you know that? No one on this earth does.

While it is strictly true that nothing can ever be completely known, that's no reason to give up. I'm not a professional, but I'm pretty confident that the most likely explanation for your recovery is successful surgery and possibly also the radiation. (Sometimes radiation is the main thing; other times it's more of a mop-op operation to catch any cells that may have been missed, in which case it's less clear whether it did any good. It can improve the odds, though.)

You can't ever know for absolute 100% sure that cancer is really gone. You also can't know for absolute 100% sure that the sun will rise in 2011. It's extremely likely, based on past behavior, but for all we know, there's a small black hole (like, about the mass of the Earth) heading towards us at relativistic velocities, about to kill us all when it intercepts the Earth during the lunar eclipse next Tuesday morning.

That's an extreme case, I realize. No reasonable person would seriously question whether the Sun will rise in 2011. It's assumed to be true. But we don't really *know* until 2011 rolls in. Until then, we have to go on past experience, and past experience says the Sun comes up every day with clockwork regularity. It's very reliable.

There is historical data (clinical, epidemiological, etc) regarding cancer treatments. It is by no means as exhaustive as our data on the Sun rising every day, but it's certainly enough to draw some conclusions about what is likely and what is not. Or, as the Mythbusters say, "Plausible" versus "Busted". The data strongly points towards surgical removal of a tumor (when it's a complete removal) being effective, while I have yet to see reliable data showing that reiki or massage have any effect whatsoever.

Keeping stress down is definitely good. Faith is, in my opinion, good (I'm a fervent Christian, and I pray regularly), but not mandatory -- one needs to find a source of peace somewhere, anyway, and if possible, also some way of gaining a positive perspective on the problem. Many find that through religion; others find it in other places, and that's fine. Does any of this aid the immune system? Indirectly, yes -- studies do show that stress can depress the immune system. However, once stress is mitigated, stress-relief doesn't really have much further benefit because being enjoyable in and of itself. (Which is plenty reason to keep doing it; just don't expect it to make cancer go away.)

Diet is important, absolutely -- but only to a point. You need adequate nourishment or you cause new problems due to malnutrition. But nutrition above that level isn't likely to help, and if you overnourish, you can create new problems -- there is such a thing as a vitamin overdose, and of course we all know the consequences of overfeeding in general.

Exercise is important too. It won't make cancer magically go away, but being in shape may help you survive the treatment. And it may help improve your quality of life, by giving you something to do and an outlet for any frustrations you may be feeling. It won't make a melanoma shrink or kill a breast tumor, but it's still good for you. (Don't overdo it, of course; running marathons is probably not necessary unless you're into that sort of thing.)

Gonzalez -- well, obviously you didn't read the original post in this thread, or even the title of it, if you think you're introducing us to something we've never heard of. Gonzalez' protocol was tested, and failed. Dramatically. It made patients *worse*.

Do we want to have the best system for "limiting" cancer or do we just want to stick with surgery, radiation, and drugs and nothing else?

What if the best system turns out to be surgery, radiation, and drugs? You seem to have closed yourself to that possiblilty. (Mind you, mainstream medicine does use methods outside of that. One that comes to mind is immune therapy. I guess that's sort of drugs, though not the usual kind.)

In any case, if you think doctors are resistant to improvement, you really are not paying attention. Orac is not merely a surgeon -- he's a researcher, studying ways to improve cancer treatment. His area of expertise is breast cancer, so probably not directly applicable to your case, but cancer is a big enough and complex enough beast that it will take a lot of people focusing on many different facets to really make serious progress. Cancer research is a hot area, and new things are coming out all the time -- better surgeries, better radiotherapy devices, better knowledge of appropriate doses, better testing to determine who will benefit the most from which treatments, better chemo regimens, immune therapy . . . . I don't anticipate the improvements stopping anytime soon.

Unless, of course, we all embrace woo. When we do that, there will be little incentive to develop new therapies, because that would mean admitting the woo isn't perfect. And people like Gonzalez will never admit their woo is imperfect.

By Calli Arcale (not verified) on 14 Dec 2010 #permalink

To Chris:
Why are you insulting me?
Orac mentioned in his post to me that he is a surgeon and I asked him in a reply to tell me what kind of surgeon he is. Is there anything wrong with that?

Yes, as is everyone else. Suck it up and do some reading.

Jake,
It is because you can answer that question for yourself in seconds if you just put in the slightest bit of effort. The answer is not hard to find.

Calli,
Though I could do without the sun rising analogy, I appreciate your comments.
I don't believe that I'd be here alive today if I didn't have the surgery.
As for the radiation in the head and neck area for melanoma post surgery... according to a study, it decreases the chances of recurrence in the area of the surgery from 20% to 10%. Sloan Kettering didn't suggest it (they said it was unnecessary) but NYU did and so I elected to do it. So did it help me to this point? Maybe. If it certainly did help me, then why didn't Sloan Kettering recommend it? Am I glad I did it? Yes because it may have helped me (even though I have no sideburn hair on the side of the treatment because of the radiation).
Have some or all of the other things that I've done and posted about helped me? Maybe, and I'm glad that I've done them.
Regarding the medical world...my problem with it is that it is too narrow minded. Turmeric shown to have significant benefit for melanoma either in mice or in vitro...don't remember which. A doctor at MD Anderson is doing some study on it. Do I sprinkle it on my vegetables? Absolutely. Broccoli shown to have benefit against cancer in some testing. Do I eat a lot of Broccoli? Yes. Like I mentioned in a post here: People should read the book "The Enzyme Factor" by a famous G.I. doctor and read about the work of Dr. Esselstyn at the Cleveland Clinic. Bring nutrition into the equation for success in treating cancer and other diseases. If the answer was surgery, radiation, and drugs to cure a cancer, I'm all for it.
As for Gonzalez, I met him, I went through his website, spoke to people that were treated by him, got input from Ralph Moss about him and everything was positive. As for that trial, why would he want to do such a trial if he knew that his "treatment" was going to be a complete failure? One of these days I'm going to find that piece that admits that the trial was flawed. People have to do more homework on him before calling him a quack. He is very intelligent, an MD from Cornell/Vanderbilt, and could have went for guaranteed high income in his specialty. Why did he do what he did? He risked so much. Additionally, he doesn't claim to have a 100% success rate with the patients that follow his program precisely. I would love to see qualified people with an open mind look at his work and decide if he is onto something or not.

Jake:

Bring nutrition into the equation for success in treating cancer and other diseases. If the answer was surgery, radiation, and drugs to cure a cancer, I'm all for it.

Show us that eating certain foods can cure cancer with real papers. That means giving us a journal, title, date and authors... not references to some self-serving books. This means you have to do a search on www.pubmed.gov.

You are making a claim, therefore you must prove the claim with real science. It is not up to us to find the references to prove your claim. Now go get those cites.

Chris,
I never said that certain foods can cure cancer and what claim have I made?
Let's see, you are arrogant, sarcastic, a mudslinger, and distort ones words...very impressive.
Are you a doctor? Oh wait, I should not ask you that for I should find out for myself by going through all of your posts, etc.
lol
Also, not pubmed, but:
http://www2.mdanderson.org/depts/oncolog/articles/07/9-sep/9-07-2.html
Have a great night, Chris!!! :)

Should we also keep open to the possibility that diseases are caused by sorcerers, and that you are one? If so, hold still while I get a matchbook.

By Gray Falcon (not verified) on 14 Dec 2010 #permalink

Jake, chemotherapy chemicals are often found in herbs and plants. Every hear of taxol? What you said was "Was it my diet?" and "Turmeric shown to have significant benefit for melanoma either in mice or in vitro...don't remember which. A doctor at MD Anderson is doing some study on it. Do I sprinkle it on my vegetables? Absolutely. Broccoli shown to have benefit against cancer in some testing. Do I eat a lot of Broccoli?"

So turmeric is being studied, big deal.

What you are doing is ignoring the very real treatment (surgery and radiation) and trying to put an uneven emphasis on your lifestyle choices. You need prove your claims that your diet, religion and other non-medical interventions have a greater effect than surgery and radiation.

You don't like my attitude? Too bad. I told you how to easily find the information about Orac, but you decided to demand that Orac give you the answer. The reason being that one should actually read more than one article on a blog and get familiar with the level of evidence discussed. After showing that you would rather behave like a demanding brat, you should not be surprised at our attitude.

No Gray, we should consider you a disease and get rid of you.
I'm an electrical engineer, graduated from a top ten engineering school with a BSEE and MSEE.
What do you do for a living?
Stand up comedy - i.e. - a Joker?

So, we have no reason not to believe you are a sorcerer. If you insist we have to consider all possibilities equally likely, we should keep that one open.

Also, I could tell you whatever occupation I wanted, and you would have no reason to doubt me.

By Gray Falcon (not verified) on 14 Dec 2010 #permalink

Jake, you do seem to have the expertise to answer the following question:

You are in your house surfing the internet during a rainy day. Then your computer stops working, and there is smoke. What is the most likely cause:

1) The software installed on the computer.

2) Really bad feng shui.

3) A nearby lightning strike.

Now, here is the other question: You have been diagnosed with melanoma, and you have been treated and are doing much better. What is the most likely reason:

1) Was it my belief in God?

2) Was it my diet?

3) Was it reiki, massage?

4) Was it the surgery?

5) Was it the radiation?

got input from Ralph Moss about him

Why in hell would you want to get input from Ralph Moss, unless it were to do exactly the opposite of what he recommended?

By T. Bruce McNeely (not verified) on 14 Dec 2010 #permalink

Chris,
How about this:
Component failure caused too much dc current to be drawn by one of the components inputs. Subsequently, a series resistor fried.

Would love to know what all of your occupations are!!! lol
Work for a pharmaceutical company?
MD who gets lots of perks from pharmaceutical companies?
Keep on eating your hot dogs, and drinking your coca colas, and downing your glasses of brandy and just PRAY that you don't get pancreatic cancer.

Gotta go ladies.

Keep sticking your head in the mud, but come up for air once in a while to sling some of it at those that would challenge the "standard"!! LOL

GONZALEZ IS THE MAN!!!

Jake

But no magic involved. I am an aerospace engineer, and I really wish you would not add to the numbers of credulous engineers who continue to demean the profession by being quack boosters (Andy Cutler, Gary Goldman, Amy Lansky and a few others). Especially one that tortures cancer patients with coffee enemas. That is just sadistic.

@Jake

You may want to follow the link in Orac's article where he discusses Gonzalez' protocol in a bit more detail, as related in the published trial. Here is the link, for ease of reference. The people on his protocol did worse than reference cases for people who do nothing.

At any rate, your "nobody knows", while technically correct, is little more than post-modernist hot air. As you must know, there is no such thing as 100% certainty, in anything (except perhaps some mathematics). Your outcome is most likely due to your surgery and follow-up radiation. As Orac has commented about some other cancers, radiation isn't always necessary as followup, since in certain cases it only provides modest improvements in recurrence. In your case, it may or may not have had much of an impact.

As to the other things you mentioned: God, reiki, massage, they probably helped you feel better or improved your outlook, which may have reduced stress and helped out somewhat. They were not likely to have had any direct effect, however, on your cancer progress.

@124 - A nearby lightning strike *is* really bad feng shui ;)

By Militant Agnostic (not verified) on 14 Dec 2010 #permalink

Wow Jake. You went from someone I thought was mainly uniformed, ignorant and capable of making silly arguments but maybe not entirely lost. But now I see you are simply another alt-med person who cannot show any evidence for their ideas and when pushed lashes out irrationally.

The pharma shill gambit? Really? Do you think this is the first time someone has come in here and said such a stupid thing? Just look up "pharma shill gambit" in that little search box and you will see how often it has been discussed and how stupid it is.

I also love how you assume everyone here lives unheathy lives. What is it with people like you and thinking that doctors and people who support science based medicine ignore these things and think diet and lifestyle are unimportant? Have you talked to a real doctor recently? I have not met one that does not press people to do improve these. I do some website support for a local heart institute and the doctors there constantly discuss healthy living with their patients. One of their main goals is prevention, they have a large smoking cessation clinic. Just because people do not support the outlandish claims made by quacks about what their diets can do does not mean they think diet is unimportant.

Militant Agnostic:

@124 - A nearby lightning strike *is* really bad feng shui ;)

I suspect Jake would just blame it on random component and not lightning, even though the room filled up with light and there was a very loud boom!

It is a shame that so many of you have bashed Nicholas Gonzalez without knowing a thing about his program. Coffee enemas are torture? It was a standard thing for many years? In the Merck manual until when?
Also, if anything that Gonzalez did was torture, don't you think there would have been an undercover person in his office with fake records, etc., and the guy would have been exposed and shut down? Let's be real, people. Let's shut down the real frauds, the Bernie Madoffs, maybe this guy Robert Young (don't know him), etc.

Bob:

Coffee enemas are torture? It was a standard thing for many years? In the Merck manual until when?

Prove it. Show that shoving caffeine directly where it is absorbed causing stress on the liver, kidneys, and bladder while keeping the patient from getting needed sleep is not torture and has actual benefits. Show us the evidence, real evidence... not a random website.

Just because something was standard practice in the past doesn't justify doing it if we now know better. We don't bleed people at random, or deprive people who are suffering from dysentery of liquids.

My wife suffered and died from ovarian cancer. She was de-bulked and did the chemotherapy protocol and then as a last ditch effort decided to go with doctor Gonzalez. She made this decision when her cancer returned and she was facing more chemo and surgery that would have left her crippled for what ever time she had left.
The medical community tortured and failed her. That's a fact! PROOF! Everyone's distain for doctor Gonzalez seems to broad brush this man's dedication and intense decision to pick up the baton from Doctors that he was sent to do a hatched job on. I can tell you that my wife's last days on this earth even if made shorter by Doctor Gonzalez's so called quackery were far superior to what she was facing by the medical community. If you want to see a living hell try 8 hours of surgery being gutted like a fish. Then do rounds of chemo with head aches and vomiting while you're all stitched up and lose teeth and be pushed to within an inch of your life with everything good and bad being destroyed in your body. I spent a fortune to keep her alive even with great health insurance. Dr, Gonzalez was a drop in the bucket. Dr. Gonzalez was straight up. He never guaranteed us a cure and was very quick to tell us we were getting to him very late in the game. He also told us how us how intense his therapy was. By the way, he lives by his own code and does Coffee enemas everyday. He also looks 15 years younger than he is. He worked with all our Doctors every step of the way without any problems. I suggest that one should not knock something without any first hand knowledge. I've never done a coffee enema but my wife never had any sleeping issues. The doctors odds were doom and gloom but her quality of life With doctor Gonzalez was far and away the better choice. I for one don't believe all I read and all one has to do is watch 5 minutes of TV and hear all the disclaimers on the ads for drugs as they seem to be the biggest pay day for the networks. Whose running the show? The drug detail men with there free trips to the Bahamas to the doctors they supply or a bag of Carrots? Cure Cancer? No way. The economy would collapse faster than it already is. Maybe one day a real study will be done without the cheating and steroids. You've all exhausted this subject. Move on to flying Saucers!

By P. Castro (not verified) on 20 Dec 2010 #permalink

To P. Castro.
Terrible that your wife had to go through the horrors of having cancer, let alone die from it.
I'm glad that you posted on here.
Too many people here have no clue about what Gonzalez is like and what he is doing, etc.
I met the man and I've spoken to 2 people that were or are actually being treated by him.
I was impressed by him and he never, ever tried to pressure me into doing his program. He even said that he hoped the clinical trial that I was considering was successful. In the end, I decided to not do anything for my stage III melanoma except change my lifestyle drastically.
I'm glad that you spoke about the coffee enemas as they have been totally ridiculed by many of those posting here. One of the 2 people that I spoke to about them said that it makes him feel better and he's not about to complain about the inconvenience because he's doing great and wants to keep it that way.
Chris keeps posting on here saying that it is torture.
I could not find any study done on it's benefits.
There is the fact that it was in the Merck Medical manual up until the 1970s so that leaves one with the impression that it is not some crazy idea from some nut job. I would like to know why it was removed from the manual.
Anyway, it's great to see people like you posting to support Gonzalez, and doing so with class.
I've found many of the anti-Gonzalez posters to be profanity throwers, mud slingers, sarcastic, and generally lacking any class. A good discussion with good arguments made for and against is the way to go but unfortunately, this is not how it goes with people that post.
Take care. Jake

Jake:

There is the fact that it was in the Merck Medical manual up until the 1970s so that leaves one with the impression that it is not some crazy idea from some nut job. I would like to know why it was removed from the manual.

I sincerely doubt it was in the Merck manual. If it actually was in and then removed the most likely reason is that the risks outweighed any benefit. Here is a hint. You will note that survival for several types of cancer has increases since the 1970s (see this article, I put the book on hold at my local library).

Think about it:

1) The intestines are a direct route to the bloodstream (hence the usefulness of suppositories for certain conditions, like nausea when a patient cannot hold down food or drink).

2) Coffee has caffeine.

3) Caffeine is a type of toxin processed by the liver, so it puts more strain on the liver.

4) Caffeine is a stimulant, and so it keeps patients from resting.

5) Caffeine is also a diuretic, which could lead to dehydration.

Conclusion: coffee enemas serve no medical purpose and cause strain on the patient, therefore it is torture.

Now, if you have anything to prove otherwise, post it. Give the journal, title, and date of any paper showing that shooting a stimulant up the wrong way provides any benefit.

To help you out, I did a PubMed search on "coffee enemas", so here is what I found:

First a review of the Gerson Regiman, the conclusion is that it didn't work:
Gerson regimen.
Cassileth B.
Oncology (Williston Park). 2010 Feb;24(2):201.PMID: 20361473

Followed by several on the effects:

Rectal burn induced by hot coffee enema.
Jones LE, Norris WE.
Endoscopy. 2010;42 Suppl 2:E26. Epub 2010 Jan 13. No abstract available. PMID: 20073005

Proctocolitis caused by coffee enemas.
Keum B, Jeen YT, Park SC, Seo YS, Kim YS, Chun HJ, Um SH, Kim CD, Ryu HS.
Am J Gastroenterol. 2010 Jan;105(1):229-30. No abstract available. PMID: 20054322

[Coffee enema induced acute colitis].
Lee CJ, Song SK, Jeon JH, Sung MK, Cheung DY, Kim JI, Kim JK, Lee YS.
Korean J Gastroenterol. 2008 Oct;52(4):251-4. Korean. PMID: 19077527

Rectal burn caused by hot-water coffee enema.
Sashiyama H, Hamahata Y, Matsuo K, Akagi K, Tsutsumi O, Nakajima Y, Takaishi Y, Takase Y, Arai T, Hoshino T, Tazawa A, Fu KI, Tsujinaka Y.
Gastrointest Endosc. 2008 Nov;68(5):1008; discussion 1009. Epub 2008 Jul 26. No abstract available. PMID: 18657805

Not such distant mirrors. Coffee enemas may be effective shock treatment.
Watts JC.
BMJ. 2000 Feb 5;320(7231):383. No abstract available. PMID: 10712032

Then it is followed by some studies (like from Gerson), critiques (but no abstracts) and another interesting paper:

Deaths related to coffee enemas.
Eisele JW, Reay DT.
JAMA. 1980 Oct 3;244(14):1608-9. No abstract available. PMID: 7420666

I thought that they at least cooled the coffee down, but it looks like there were a few burns! How is that not torture? And it could be effective for shock treatment? Isn't that another form of torture?

Now I really want to see what evidence shows there is any benefit. I looked, but could not find it (except from those promoting the stuff), so you have your work cut out for you.

So you think that Gonzalez and Gerson did it for torture? Can you answer this question?
Sounds like a good way to get your license revoked, no?
I'm certain that the coffee must cool down (I'm not sure why I even responded to that).
Coffee enemas don't cure cancer. They are supposed to "help the liver get rid of toxins due the process of destroying the cancerour tumors". Do I have any evidence that it works? No. Let me see if I can find sufficient evidence that it was in the Merck manual.
Regarding those that did the coffee enemas or had a loved one that did the coffee enemas, are you saying that they are lying about their experience regarding the coffee enemas? Please answer this question.
Finally, why is it that Gonzalez has not been shut down?
Please give me your thoughts about this.

Jake, are you being deliberately obtuse. First of all, we're not saying needless torture was Gonzalez's intention, simply that it is the end result. Likewise, the testimonials were not dishonest, merely erroneous. Good intentions do not equal good actions, and human beings can make mistakes.

Secondly, he wasn't shut down simply because it's hard to convict people like him. Technically, Jack the Ripper was never arrested, was what he did right? Most of us have an understanding of right and wrong beyond "don't get caught".

Finally, if you have no evidence something works, then the null hypothesis rules: It doesn't work. If it was once in the Merck manual, that means nothing but that science marches on. Unlike some people.

By Gray Falcon (not verified) on 21 Dec 2010 #permalink

Jake:

Coffee enemas don't cure cancer. They are supposed to "help the liver get rid of toxins due the process of destroying the cancerour tumors". Do I have any evidence that it works? No.

It is not logical to help the liver get rid of toxins by adding more toxins. Caffeine has several effects on the body, and is a toxin itself.

Here is a case report of what can happen with coffee enemas (and I chose it because it is free online): Polymicrobial enteric septicemia from coffee enemas:

Despite treatment, including liver extract administration and frequent coffee enemas until the day before admission to our hospital, hepatic failure occurred. Admission paracentesis yielded sterile ascitic fluid, but stool culture and two separate sets of blood cultures grew Salmonella enteritidis group D and Campylobacter fetus subspecies intestinalis. The patient died before further gastrointestinal evaluation could be completed, and permission for autopsy was not granted.

Yes, with results like this in the medical literature, it is up to you to find the real science.

Here is another free article from the 1980s for you to peruse: Unproved dietary claims in the treatment of patients with cancer.

So Nicholas Gonzalez has finally been shut down? When did that happen? I looked at his website, and it seems that it is business as usual. But, Jake, if you have a notice that his clinic has been shut down, I would really love to see that.

Gray Falcon, yes, you are right. They don't consciously mean to torture their patients. There is a rather prurient history around enemas, including the cereal inventor Kellogg fascination with clearing everything out with enemas (but at least he just used yogurt and water, though he used lots of water). Perhaps one just has to step back from the hype in order to see the whole picture, and take in how ridiculous the whole theory is, and how it is so dangerous.

Chris,
I guess you didn't realize that the questions in my last post (139) were directed at you.
Maybe you would like to answer them?

In all due respect. Show me air? We can't see it but we know it's there. Proof comes in many forms. That's why I've requested (tongue in cheek) that this forum move onto Flying saucers. Those that have seen them or something completely unexplainable believe 110% in what they saw. Those that never witnessed it call that small minority crack pots. After witnessing for ten years my wife battle her medical mystery tour I now consider myself somewhat of an authority on diagnosing ones general health by ones weight and skin tone. It's not so hard to see the walking heart attacks and strokes waiting to happen. Most people would say that Dr. Oz is quite a healthy person who looks fabulous for his age. Sleep diet and exercise seems to be the antidote for potential health ridden disasters. In all honesty Dr. Gonzalez looks like he has one up on Dr OZ.
For all the misguided mud slinging I've witnessed on this site I must say the guy is really trying and not getting a free ride on the backs of his doomed patients. The medical communities fight against cancer is dismal and in my humble opinion on a par with space exploration and the fight against illegal drugs. So when you see someone who's trying to come in the back door or think out of the box think twice. Or at least own up to those of us who have experienced some positive results. How many people die of cancer each year? Its like fighting a non stop war. So poor little Nick Gonzalez looses a hundred people in lord knows what kind of time frame. What's that? 1/100th of one percent of the hundreds of thousands who die each year? Someone needs a reality check? My wife died from cancer. Nick Gonzalez couldn't save her anymore than Mount Sinai Could. However, My wife decided to die on her own terms and before she did she soared working her program. She never felt better. Working out, prayer sessions with her close personal friends and cleaning her body out. After a month the nurses at Mount Sinai said they'ed never seen blood so clean. Mind you I also spent close to twenty-thousand dollars to put her smile back because of the teeth and bone loss from chemo. Do the math? More rounds of chemo where the results are proven not to work as well the second time around after they go gut a little more of you and cripple you or try something else and hope for a miracle? Desperate people do desperate things and for anyone to think that Dr. Gonzalez is a charlatan preying on the terminally ill brings nothing to the table but negativity. The snake oil people are out there.
Nick Gonzalez hasn't gotten any further than Sloan working with Carrots instead of the mega bucks that go through all the cancer funds and the medical miracles that do come down the pike are a blessing. I've developed life long friendships with some of the doctors that cared for my wife. I have not seen or spoken to Dr. Gonzalez other than to tell him that my wife's last wishes were that when she was gone if anyone wanted to donate money to the American Cancer fund would I please have them donate to Dr, Gonzalez and his work. He was heartbroken and emotionally moved. She went nuts every time we would go for chemo rounds because always on the counter of the office's were pure sugar candies they would give to the patients. It will be 5 years this Feb 22nd. Since she passed. Her mother also Died on the same exact date 8 years before her from Pancreatic Cancer. She had a biopsy at Sloan and was told she was fine until the pain continued and they went in and took a look and gave her 3 months to live. They had it completely wrong. You show me a few disgruntled coffee enema people and I dare say there are thousands doing it for some reason without any complications and who am I to judge if it makes them feel better. A horse knows when he has a rider on his back. No one is perfect but Dr. Gonzalez should be in the class of the gifted children with potential instead of being thrown in the special ED class because there's not enough money in the system to separate the brilliant ones from the mentally challenged. Happy Holidays to all and enjoy what you have. It's once around the path.

Jake:

I guess you didn't realize that the questions in my last post (139) were directed at you.

Excuse me? You said that Gonzalez was shut down, I see no evidence of that. Where is it? Did you actually read my comment? Where is the evidence that a coffee enema does anything other than torture?

Mr. Peppy does not seem happy from his paragraph free comment. I asked for scientific evidence, not a random website cite... yet all you offer is a random website cite. No, that is not sufficient. Show us real evidence.

One could make the case that the evidence is the many who fork over good money to support the industry. Good or bad people are getting something out of it or why do it? My proof was seeing what it did for my wife. i don't need to read that in a medical journal. This isn't something new? One man's floor is another mans ceiling. Ying and yang already!

Peppy:

One could make the case that the evidence is the many who fork over good money to support the industry.

Which industry?

Sorry Chris,
I was referring to colonics and the many who pay hard earned money and do Coffee enemas.
Obviously some swear by it like my wife did. Having seen first hand all the agony she went through it really did do wonders for her and she felt great. She was however also on an amazing amount of supplements and a diet as clean as fresh snow. Like I said, who am I to judge. We're just scratching the surface.

Lots of people paid good money for Ford Pintos.

By Gray Falcon (not verified) on 22 Dec 2010 #permalink

Peppy: Great post.
Chris: Take a look at my post. I asked you a few questions which you have not answered.
Also, regarding the post about Gonzalez being shut down, you have it wrong.
Read it again.
It says:
"Finally, why is it that Gonzalez has not been shut down?
Please give me your thoughts about this."

Chris:
Criticizing Peppy because his long post did not contain paragraphs?
Is that the best that you can come up with about his well written observations regarding his wife, Gonzalez, etc.
If it is, that is absolutely pitiful.

How about, he's given one testimony, and that's it. A case study is a starting point, not an ending. One needs to make sure that it is, in fact, the medicine having the effect and not the patient's expectations.

Also, the fact that Gonzales hasn't been shut down yet doesn't mean he's right, only that he hasn't been caught.

By Gray Falcon (not verified) on 22 Dec 2010 #permalink

So exactly where is the science that supports coffee enemas? One anecdote does not count. Plus Peppy seems to admit that the people promoting the torture are an industry.

Jake, I am not answering any of your silly questions since I have given you several papers that refute everything you said. You need to provide evidence to support Gonzalez and torturing sick people with coffee enemas. You made the claims, you need to support them with papers that have the same level of caliber that I have presented.

Yes, Jake, I did misread your statement. The real question should be why would anyone in their right mind go to Gonzalez or Robert Young, or get the Gerson technique when the studied results are so dismal.

All one has to do is a PubMed search on "coffee enemas" to find the case studies of injury and death. The very few positive papers come from the Gerson/Gonzalez industry.

Interestingly, coffee enemas were mentioned in the Merck Manual as part of an entry on types of enemas:

Retention enemas: The patient must first be told that the solution is not to be expelled but retained within the rectum until the next bowel movement takes place. Administration should be extremely slow to avoid stimulating peristalsis. The principal types of retention enema are:

Emollient: Mix 1 to 2 tsp. starch with sufficient cold water to make a thin paste; add 5 oz. boiling water, and boil for 5 min.
Lubricant: 3 to 6 oz of olive, cottonseed, or mineral oil.
Medicated: 6 to 8 oz. coffee, or 1 oz. whiskey added to 6 oz. isotonic saline, may be given for their stimulating effect. Other medicines should be diluted with 2 to 4 oz. of water or olive oil.

Seems to me that they were used to stimulate peristalsis in severe constipation. There's no mention of "toxin-clearing" activity. It was apparently dropped from the Manual for space considerations, rather than on orders from the Medical-Pharma-Industrial-Illuminati-(your bogeyman here)-conspiracy, since it was an obsolete and trivial treatment (IMHO).

By T. Bruce McNeely (not verified) on 22 Dec 2010 #permalink

Chris,
I asked you the following questions:

1) So you think that Gonzalez and Gerson did it for torture?

2) Regarding those that did the coffee enemas or had a loved one that did the coffee enemas, are you saying that they are lying about their experience regarding the coffee enemas?

3)Finally, why is it that Gonzalez has not been shut down?

These "silly" questions are based on your earlier posts. Are you afraid to answer these questions?
What do you have to lose?

To T. Bruce McNeely:
I clicked on that link and it led me to search results. I could not find the information that you posted. Can you help because I'd like to read all of it.

Speaking for myself,

1. That wasn't their intent. It was, however, the result.

2. Lying, no. Mistaken, yes.

3. Largely because influential politicians choose to promote woo, regardless of how much it hurts people. Also because there are few ways TO shut such a scam artist down; the way it's supposed to happen is that the licensing board pulls his license, but they generally don't have the resources to deal with such cases.

The same as Scott said. Though I believe Gonzalez is so wedded to his idea that he cannot denounce it, and is probably deluded himself. And it is very difficult to shut down quacks, especially if they are licensed MDs, though some have had to go to Mexico.

Jake, why are you defending the programs that have been shown to be worse for patients than real therapies? What is your motivation? Are you part of the coffee colonic industry? Is this why you won't or can't come up with evidence to support its use?

Further to my comment @155:

I can't seem to make a working link (I'm an HTML newbie). You can find it with a Google search for "coffee enema Merck manual". It will be the third result on page 1. I have copied the result below:

The Merck Manual - Coffee Enema - ArticlesEnema information excerpted from The Merck Manual - Tenth Edition.
www.coffee-enema.ca/merck.htm - Cached

By T. Bruce McNeely (not verified) on 22 Dec 2010 #permalink

I should also add that the rest of that website has all the blithering idiocy about coffee enemas that you could ever want.

By T. Bruce McNeely (not verified) on 22 Dec 2010 #permalink

To Scott and Chris:
Here is what was asked and what was answered:

1) So you think that Gonzalez and Gerson did it for torture?
1. That wasn't their intent. It was, however, the result.
HOW DO YOU FIGURE THAT THIS IS TORTURE? YOU HAVE TESTIMONIALS FROM THE PEOPLE ABOVE AND AND ADMISSION FROM DR. HIROMI SHINYA, A WELL RESPECTED G.I. MD THAT HE AND MOST OF HIS FRIENDS DO THEM. NOT ONE OF THEM APPEAR BOTHERED BY THEM. ON THE CONTRARY, IT GIVES THEM RELIEF. AS FAR AS THE REPORTS OF DEATH OR INJURY FROM IMPROPERLY DONE OR EXCESSIVELY DONE COFFEE ENEMAS...THEY SPEAK FOR THEMSELVES. DO IT INCORRECTLY AND DO IT TOO FREQUENTLY, YOU ARE ASKING FOR TROUBLE. HOW MANY TIMES HAS INCORRECT ADMINISTERING OF CHEMOTHERAPY CAUSED DAMAGE OR DEATH?
YOU HAVE NO CASE HERE AT ALL ABOUT THE SAFETY OF COFFEE ENEMAS. YOU CAN SAY THAT THERE IS NO PROOF THAT THERE IS NO PUBLISHED DATA INDICATING A BENEFIT FROM DOING THEM, AND THAT IS TRUE, THOUGH THERE ARE MANY TESTIMONIALS FROM PEOPLE THAT SAY THAT THEY HELP THEM "FEEL BETTER". BOTTOM LINE: COFFEE ENEMAS ARE NOT DANGEROUS WHEN DONE PROPERLY, WHICH IS NOT DIFFICULT TO DO, MAY HELP YOU FEEL BETTER, ACCORDING TO THOSE THAT HAVE DONE THEM, AND SOME SUGGEST THAT THEY HELP THE LIVER REMOVE TOXINS FROM THE BODY, THOUGH THIS HAS NOT BEEN PROVEN TO BE TRUE OR FALSE.

2) Regarding those that did the coffee enemas or had a loved one that did the coffee enemas, are you saying that they are lying about their experience regarding the coffee enemas?
2. Lying, no. Mistaken, yes.
SO THEY ARE NOT LYING BUT THEY ARE MISTAKEN ABOUT WHAT THEY ARE SAYING?? DOES THIS MEAN THAT THEY TRULY BELIEVE THAT THE COFFEE ENEMAS MAKE THEM FEEL BETTER BUT THEY ACTUALLY DON'T MAKE THEM FEEL BETTER. IS THE COFFEE BOOST DOING SOME MIND ALTERING? WE ARE ONLY TALKING ABOUT HOW THE COFFEE ENEMA MADE THEM FEEL, NOT IF THEY BELIEVE THAT THE ENEMAS ARE HELPING THE LIVER TO ELIMINATE TOXINS. IF SOMEONE COMES TO YOU AND SAYS THAT THEY FEEL BETTER WHEN THEY DO "X", YOU EITHER BELIEVE THEM (AND MAYBE TRY WHATEVER IT IS) OR YOU BELIEVE THAT THEY ARE LYING.

3)Finally, why is it that Gonzalez has not been shut down?
3. Largely because influential politicians choose to promote woo, regardless of how much it hurts people. Also because there are few ways TO shut such a scam artist down; the way it's supposed to happen is that the licensing board pulls his license, but they generally don't have the resources to deal with such cases.
THIS IS LAUGHABLE AS WELL. THE POLITICIANS FOLLOW THE MONEY. AND IF THEIR SUPPORTERS ARE MDs, THE AMA, PHARMACEUTICAL COMPANIES, ETC., THEY WOULD CERTAINLY NOT SUPPORT "ALTERNATIVE MEDICINE" UNLESS THEY FELT THERE WAS REALLY SOMETHING THERE. THAT IS WHY THEY DID THE STUDY WITH COLUMBIA.
ALSO, IF YOU DON'T KNOW, GONZALEZ LICENSE WAS SUSPENDED IN 1992 OR 1993 FOR MALPRACTICE. DON'T YOU THINK THAT HE WOULD BE UNDER THE MICROSCOPE, MAYBE SOME UNDERCOVER "PATIENTS" SENT HIS WAY WITH FAKE IMAGES AND TEST RESULTS? ALSO, GERSON THERAPY IS NOT ALLOWED HERE. I WOULD SUSPECT THAT THEY FOUND NO EFFICACY. THEY CHECKED OUT GONZALEZ CLAIMS BEFORE THEY DID THIS STUDY AT COLUMBIA. OBVIOUSLY HIS RESULTS PERSUADED THEM TO DO THIS STUDY. WHY DID HE DO THIS? DID YOU READ THAT HE WAS EXPECTED A 3:1 IMPROVEMENT IN SURVIVAL VS CHEMO? WHY SET YOURSELF UP FOR FAILURE IF YOU KNOW THAT YOUR PROGRAM IS B.S.? I REALLY HOPE THAT THE GOVERNMENT LOOKS INTO THIS TRIAL AND DOES A FAIR ANALYSIS AND EITHER SAYS THAT THE TRIAL WAS A FARCE OR REVOKES GONZALEZ' LICENSE. BY THE WAY, GONZALEZ WAS LOOKING FOR AN IMPROVEMENT OF 3:1 IN AVERAGE SURVIVAL TIMES, NOT A CURE IN THIS STUDY DEALING WITH NON-EARLY STAGE PANCREATIC CANCER. HE CAN CLAIM LONG TERM SURVIVAL WITH OTHER CANCERS IF THE PATIENTS CONTINUE TO FOLLOW THE PROGRAM.
AS FAR AS THE GOVERNMENT NOT HAVING THE RESOURCES TO GO AFTER A GUY THAT YOU GUYS ARE ESSENTIALLY CALLING A DANGEROUS QUACK, I WILL JUST MENTION THIS: MAJOR LEAGUE BASEBALL AND PERFORMANCE ENHANCING DRUGS INVESTIGATION!!!!
I WANT THE TRUTH AND HOPEFULLY YOU GUYS DO TOO.
I MET THE MAN AND I CONCUR WITH THE GUY ON HERE THAT SAID THAT GONZALEZ EASILY LOOKS TO BE IN BETTER CONDITION THAN DR. OZ. THE GUY IS 62 AND COULD PASS FOR 45. MAYBE IT HAS NOTHING TO DO WITH HIS PROGRAM OR MAYBE IT DOES.
GONZALEZ HAS BEEN ON SHOWS ON TV WITH AND WITHOUT PATIENTS THAT ARE SUCCESS STORIES. AM I SURE THAT HE IS A REAL DEAL? NO, NOT 100%, BUT I WOULD DEFINITELY BET ON HIM BEING REAL RATHER THAN A FRAUD.

Oh, oh... we have invoked the ALLCAPS troll! So, Jake, do you really think pounding on the keyboard and shouting is a valid substitute for evidence? By the way, testimonials are just anecdotes and are not data.

Chris,
You can believe what you want. I was passionate about what I wrote but not angry at all.
As I wrote, if a guy like Hiromi Shinya, MD and his friends are doing coffee enemas, and a few others on this site had no problems with it and you discovered that it was indeed in the Merck manual years ago, then you are WRONG about them being a form of torture. You won't admit that to me but hopefully you will to yourself.
By the way, I believe that there is some thing called anecdotal "data", no?
Ask Ralph Moss, who knows that chemotherapy is very effective for certain cancers, what he thinks of Gonzalez' records and successes (No, Ralph Moss is certainly not just an alternative medicine proponent for those of you that ignorantly think he is. He is interested in ALL kinds of successful cancer treatments). Ask the congressmen that said Yea to the funding for the Columbia U. trial if they think Gonzalez was onto something? Ask the people that have been successfully treated by Gonzalez. They are all lying, right?
All he has right now is anecdotal data and I hope that one day he gets another chance to prove himself in a highly secure study. I'm sure that all of his patients that are thriving will want that as well.

Jake:

All he has right now is anecdotal data and I hope that one day he gets another chance to prove himself in a highly secure study. I'm sure that all of his patients that are thriving will want that as well.

And a trail of dead patients: An NCI-sponsored study of Gonzalez therapy, which is similar to the Gerson diet, showed that patients with inoperable pancreatic adenocarcinoma who underwent standard chemotherapy with gemcitabine (Gemzar) survived three times longer and had better quality of life than those who chose enzyme treatment, which included pancreatic enzymes, nutritional supplements, detoxification, and an organic diet.

Plus: âGonzalez Regimenâ for Cancer of the Pancreas: Even Worse than We Thought (Part I: Results):

The JCO report soundly refutes Gonzalezâs claims. The treatment does not prolong the lives of patients with cancer of the pancreas; it substantially shortens their lives. It does not increase patientsâ sense of well being; rather, it makes their quality of life âmuch worse.â

I suggest your next post contain actual evidence, and be sure to include this paper, it is the research from Columbia Univ. that you keep mentioning, and the subject of this blog post:

J Clin Oncol. 2010 Apr 20;28(12):2058-63. Epub 2009 Aug 17.

Pancreatic proteolytic enzyme therapy compared with gemcitabine-based chemotherapy for the treatment of pancreatic cancer.

Chabot JA, Tsai WY, Fine RL, Chen C, Kumah CK, Antman KA, Grann VR.

Columbia University Mailman School of Public Health, 722 W 168th St, Rm 734, New York, NY 10032, USA.

Jake--

It sounds like you have an unusually good breed of Congressmember, if you think that the ability to get them to vote for something proves that it's a good idea.

Passionate or no, all caps is *harder to read* than mixed case text. It's not just that it seems like you're shouting, to some people, it's that you're making the reader do more work, for no good reason.

Four paragraphs of pure Caps Lock doesn't say "Look at me, I'm passionate!", it says "Look at me, I wear underpants on my head!"

More on topic, you use as the sole criteria for medicine working that it makes the user "feel better". So why is methamphetamine illegal? Feeling better isn't the same as being better.

The real irony is that so many people accuse mainstream medicine of only "covering up symptoms".

Finally, here's a little explanation of the concept of "burden of proof". Let's say I decide your dental problems are caused by your placing a curse me. Is it up to you to prove that you aren't a sorcerer, or me to prove that you are?

By Gray Falcon (not verified) on 22 Dec 2010 #permalink

To Vicki:
So why do you think the congressional group voted to do this study? Gonzalez paid all of them off? LOL
Secondly, yes I want you to do more work in reading what I have to say!!!
Is this all that you have to say. Pretty empty. I guess the all caps was too difficult for you, so you stopped reading.

To Gray Falcon:
Here are more CAPS LOCK WORDS:
REGARDING YOUR POST:
More on topic, you use as the sole criteria for medicine working that it makes the user "feel better". So why is methamphetamine illegal? Feeling better isn't the same as being better.
I SAID THAT COFFEE ENEMAS MAKE THE PATIENT FEEL BETTER. I NEVER SAID THAT IT MADE THEM BETTER NOW, DID I?
DO YOU HAVE ADD? GO GET SOME DRUGS FOR IT...THEY MAY WORK...OR THEY MAY NOT AND YOU MAY JUST GET THE SIDE EFFECTS. LOL

It really is funny answering all of you.

If you can't show they make the patients better, then there's really no point to it. If the evidence shows that it causes harm but no good, then of course one shouldn't use it. For example, using caps lock may make you feel better, but everyone thinks your just being petulant and rude.

Also, green curry contains coconut milk. This is as relevant as your bringing up mainstream drugs.

By Gray Falcon (not verified) on 22 Dec 2010 #permalink

I have a post in moderation, with a link to the ScienceBasedMedicine article on the Columbia study mentioned in the second paragraph of the blog article (the actual paper of the study is behind a pay wall). The results of the study show that the patients doing the Gonzalez protocol did not feel better, and had worse outcomes. So, Jake, go to the top of this page and click on all the links in the second paragraph. Come back when you have read them all.

Quackwatch is not a reputable website or source. It is obsolete.

Citing it is equivalent of your enemies citing whale.to.

By augustine (not verified) on 22 Dec 2010 #permalink

Ask the congressmen that said Yea to the funding for the Columbia U. trial if they think Gonzalez was onto something

So why do you think the congressional group voted to do this study? Gonzalez paid all of them off?

No, the congresscritters "voted to do this study" because they are scientifically illiterate critical thinking impaired nincompoops who were elected by an even dimmer electorate, half of which thinks the Flintstones is a documentary and a quarter of which thinks the sun goes around the earth.

Seriously, this is the second lamest argument from authority ever. The only thing lamer is invoking the British royal family in support of homeopathy.

By Militant Agnostic (not verified) on 22 Dec 2010 #permalink

Oh, good. My comment has been approved. Going back and reading the article again reminded me that the poor patients in Gonzalez arm of the study had their lives shortened, and their well being compromised. It was definitely not beneficial.

@170

Jake, your postings here has to be some of the most unintentionally funniest postings I have ever seen.

The sheer amount of ignorance, yelling, lack of logic, and disingenuous thinking has given me a good laugh, right in time for the holidays.

Novalox: You must be onto something (or on something?)...you can tell that a person is yelling from an email?...patent it buddy...that is so idiotic.

You and many of the other people on here dismiss the stories from the people that have been treated by Gonzalez...successfully. Several of his patients have been on TV with him. I've spoken to 2 of his patients (and I didn't get in contact with them thru him). Are they all lying? If you simply dismiss him as a quack, you are ignorant. Why can't they shut him down? I just get hogwash answers from you nonbelievers.

Criticism of coffee enemas...as I've said several times here...why does a well known GI doctor, who invented parts of intsruments for the colonscopy, do them? Because he believes in them. He seems to be a credible guy, no? We are talking about a GI doc who deals with the "other end" all of the time...not a chiropractor. NOBODY HAS RESPONDED TO THIS. It was shown on this site that the coffee enema was included in the Merck Medical Manual. Is there any published proof that it does help the liver eliminate toxins? No. Is a study forthcoming? Doubt it. Show me a study from a reputable scientist that proves that it cannot be of any help.

Criticism of Ralph Moss? As I said before, he is interested in ALL methods of curing cancer, conventional and non-conventional. Do a little research about him. If you just dismiss him as another quack, another "altie", you are ignorant, period.

Read about Nicholas Gonzalez, Hiromi Shinya, Caldwell Esselstyn...all MDs that have gone beyond the "Give 'em drugs" "solution. Unless you enjoy sticking your head in the sand (or coffee beans!).

Augustine, can you show that Quackwatch is disreputable. Whale.to includes the famous "burned by a Satanic ley line" story and such. Don't just make accusations, back them up.

Jake, most people know that allcaps is the equivalent of shouting. Not knowing that in 2010 suggests that you have very little sense of reality.

And yes, he is a GI doc, not a chiropractor. This is because we understand right and wrong on a level higher than "these people good, those people bad!"

Also, if we really have to consider all possibilities, then there are documented cases of people being executed for witchcraft in Europe, and then others recovering from illness.

By Gray Falcon (not verified) on 23 Dec 2010 #permalink

Hold on, there was a typo in the last post.

The reason why we didn't address the fact that Gonzales is a GI doc is because it's irrelevant. Wrong is wrong, regardless of who says it.

On a related note, you never properly answered my question about sorcery, you just accused me of being a comedian. I'll take that as a compliment, after all, what does a trickster do but expose the foolishness of the pompous and arrogant?

By Gray Falcon (not verified) on 23 Dec 2010 #permalink

Jake--

Maybe someone paid them off. Maybe someone fooled a few of their constituents, who made a bunch of phone calls, and since nobody was calling to say "don't do this" they decided it would get some votes. Maybe someone convinced them that the study would produce jobs in their districts. Maybe they were persuaded by someone who talked about a dying relative. Maybe they really do believe in this stuff.

Congressmembers average richer, better educated (the last I heard, there was exactly one without a college degree), older (there's a lower age limit), and more male than the population. None of that makes them any less likely to believe in nonsense.

Jake, have you actually read the blog post? Or any of the articles linked to in the second paragraph? The second article I linked to in my finally approved comment goes into the political shenanigans, so go and actually read it. It really doesn't matter if Gonzalez is a real licensed doctor, he is making sick people more miserable and killing them faster than the conventional treatment. I linked to multiple papers showing that.

Now stop whining and present some real evidence.

@178

More unintentional humor and ad hominems from Jake!

Keep it up, you have me at a good laugh!

Criticism of coffee enemas...as I've said several times here...why does a well known GI doctor, who invented parts of intsruments for the colonscopy, do them? Because he believes in them. He seems to be a credible guy, no? We are talking about a GI doc who deals with the "other end" all of the time...not a chiropractor. NOBODY HAS RESPONDED TO THIS.

Oh well then, here we go.
I presume you're referring to Hiromi Shinya. Yes, he was a major contributor to colonoscopic surgery, and a developer of instrumentation that is still being used. However, he appears to have recently gone to the far side. Anyone who recommends kangen water has to be evaluated skeptically.

By T. Bruce McNeely (not verified) on 23 Dec 2010 #permalink

Gray Falcon:
At least T. Bruce McNeely was "smart" enough to figure out that the GI doc I was referring to was Hiromi Shinya, not Gonzalez. See, you are just another doubter that doesn't do any research on the ones that they are criticizing.

T. Bruce: Gone to the far side? Do yourself a favor and read his book "The Enzyme Factor". As for the Kangen Water...I believe that you will find that the Kangen water machine is a medically approved device in Japan...but maybe Japan has gone "Woo". LOL

Chris: Again, are all of Gonzalez' "satisfied customers" liars? Or are they all just going through spontaneous remission? I am very curious to see how all of this plays out. Was it indeed a "skewed" study as Gonzalez claims, or was it the whole truth and nothing but the truth? Do you ever wonder why Gonzalez would have gone through with this trial if he knew that he had a bogus treatment? You know that this bad publicity is going to hurt his reputation and that he is going to lose customers. He was quoted as saying that he expected his treatment to show an improvement in survival time by 3:1.

In the spirit of Christmas, I just want to say: Thank God for "Saint Nick" Gonzalez!!! Oh wait, should I take that back because I used the word "God"? LOL

You hadn't given a name, Jake. I just assumed based on your implications. Interesting you point out my single mistake and ignore everything else I've said.

We've already explained, repeatedly, why testimonies alone are not good science. The testimonies alone are not enough to tell whether it was the treatment or the natural course of the disease, which is why we have double-blind studies. Of course, since you didn't figure out that all caps only makes you look like you're screaming in 2010, I can't say you're very quick on the uptake.

By Gray Falcon (not verified) on 23 Dec 2010 #permalink

Jake, did you even look at the link I provided? The claims for Kangen water are ridiculous for anyone who knows basic chemistry. Whether the Kangen machine is a medically approved device is irrelevant in the face of this.
I don't plan to read "The Enzyme Factor". It saves me a lot of time and aggravation if I don't read books by authors who have taken leave of their senses.

By T. Bruce McNeely (not verified) on 23 Dec 2010 #permalink

Again, are all of Gonzalez' "satisfied customers" liars? Or are they all just going through spontaneous remission?

They're the lucky ones whose cancers were less aggressive and didn't kill them (yet). The far more numerous "customers" he killed aren't talking about it.

Jake:

Again, are all of Gonzalez' "satisfied customers" liars?

I only have your word that Gonzalez has satisfied customers. They may not be liars because as far as the scientific literature goes, they may not exist. You have not posted anything that is real evidence, for all I know you are just making them up. Even if they do exist, it is just anecdotes: and the plural of anecdote is not data.

The trial that you keep talking about was canceled when it was shown that the Gonzalez patients were dying quicker and were in pain. It is explained in the ScienceBasedMedicine article I linked to that explained the paper about that trial, which is behind a pay wall. So go and read it!

As far as the rest of your questions, read the ScienceBasedMedicine article I linked to!

Gray:
I only ignore the ridiculous things...sorcery, etc.
Regarding you stating in your last post:
"We've already explained, repeatedly, why testimonies alone are not good science. The testimonies alone are not enough to tell whether it was the treatment or the natural course of the disease, which is why we have double-blind studies."

I largely agree, however I believe that the testimonies are an important starting point and that if you do a study with a "large enough" number of patients, and the results are overwhelmingly favorable, you don't even need a double-blind study. I believe that this is considered "fast track". I don't believe that Gonzalez has done this and I do understand why many people are skeptical. However, I have seen his educational credentials, met the man, spoken to 2 of his successful patients, spoken to Ralph Moss about him, seen what some bigshots at Nestle's and Proctor and Gamble have said about him, seen him on TV with some of his successful patients and because of these experiences, I believe that he is legitimate. I will admit that the trial results make me more skeptical but I know how much corruption goes on in this country and so it wouldn't shock me one bit if the trial was "corrupted".

T. Bruce:
I don't remember much about chemistry anymore...sorry.
But why would this machine be approved as a medical device in Japan if BASIC CHEMISTRY would tell one that it is bogus? Chemists over in Japan could really embarass those that approved of this, couldn't they? Furthermore, I can't believe that a guy who was talented enough to invent things for colonscopy would recommend something that basic chemistry tells you is a farce. Maybe I will set up an appointment with him and question him about the science behind Kangen water.
Please tell your buddy at skeptoid to get his facts straight in his paragraph dismissing Dr. Shinya's support for using Kangen water. Dr. Shinya is NOT retired. I just called his office in NYC. He'll be back from his office in Japan in April.

Jake:

However, I have seen his educational credentials, met the man, spoken to 2 of his successful patients, spoken to Ralph Moss about him, seen what some bigshots at Nestle's and Proctor and Gamble have said about him, seen him on TV with some of his successful patients and because of these experiences, I believe that he is legitimate.

Why should we believe you? You have ignored the evidence we have given you, resorted to childish rants in allcaps and have been generally clueless. In short, you have no credibility.

As far as we know, you work for Gonzalez and are attempting to do public relations. In the past I had a similar conversation with someone on the listserv I was on for my son's disability, it turned out she was an employee of a quack doctor trying to drum up business. I see no reason why you are not doing the same.

Scott:
Don't you think that the loved ones of those that he "killed" would be talking? I did see a post from a loved one (husband) of one that died despite getting treatment from Gonzalez and he had great things to say about Gonzalez and that his wife wished for donations to be made to his practice upon her demise. I guess this guy was lying too? I guess everyone that posts about Gonzalez in a positive way is lying, right?

Chris: Gonzalez can provide you with evidence that he has many many patients that have thrived under his care. Ralph Moss saw it. Maybe you can pose as an altie writer and get access to that information as well? :)

I'm not making up anything here but neither patient had pancreatic cancer. One had breast cancer and another had melanoma...both stage IV.

You can correctly state that Gonzalez has not scientifically proved that his program has merit when the standard of proof is a double blind study. Fair enough. Cancer is a huge issue, and I have first hand experience with it. I would just want our "wonderful" government to do a fair, thorough investigation of this trial, of Gonzalez, and then either shut him down or put more money into his program and see if they can make it more effective, streamline it if necessary (I wouldn't want to do a coffee enema if I didn't need to) and give their stamp of approval for it being a valid treatment option for cancer. Wouldn't it be great to see a debate by prominent scientists on the benefit, or no benefit, of coffee enemas, and on the benefit, or no benefit, of ingesting pig pancreatic enzyme pills?

Chris:
There you go again.
When you don't like what you read, you resort to name-calling and other criticisms.
I don't ignore evidence.
I don't work for Gonzalez. LOL
My words: "I will admit that the trial results make me more skeptical but I know how much corruption goes on in this country and so it wouldn't shock me one bit if the trial was "corrupted"."
Does this sound like somebody who works for Gonzalez????
What makes me any less credible than you?
What is your profession?
I am an electrical engineer.

Jake @190

But why would this machine be approved as a medical device in Japan if BASIC CHEMISTRY would tell one that it is bogus?

Looking directly at the company's website, the certificate in English says that the device is licensed.
http://www.enagic.com/technology_certificates.php

I don't see anything on there about it being approved for anything.

And as for @192

Wouldn't it be great to see a debate by prominent scientists on the benefit, or no benefit, of coffee enemas, and on the benefit, or no benefit, of ingesting pig pancreatic enzyme pills?

Did you read the Science-Based Medicine article Chris linked? This has been done. The verdict, whether or not you like the result, was no benefit.

What's making you less credible than other commenters is that you are ignoring evidence.

I am an aerospace engineer. I don't ignore the evidence like you are doing, and aren't you glad there is no alternative aviation?

I don't even expect you to believe me, which is why I posted a list of several scientific journal articles to support my statements. I am baffled why I am expected to believe you had personal conversations, much less that you even remembered correctly what was said... since you seem to have a special data filter. That is called hearsay evidence, and it does not work here just as it does not work in a court of law.

So please, for the third or fourth time, read the ScienceBasedMedicine article by Kimball Atwood! It has an analysis of the study (so you don't have to pay to read it), plus it goes into the political shenanigans. Go to the second paragraph of this page, and click on the blue letters that say "Kimball Atwood." Is that really so difficult? Surely as an electrical engineer you have learned how to click on a link in an HTML page?

I also posted several case studies on the dangers of coffee enemas, plus the issues with doing them, and that the Gerson/Gonzalez/Kelley cancer treatments are useless. So for the fifth or sixth time, if you have real evidence that giving patients stimulants directly into the intestines has a benefit: present it! Otherwise drop the whole issue, and stop promoting the needless torture of sick patients.

Jake:

"I will admit that the trial results make me more skeptical but I know how much corruption goes on in this country and so it wouldn't shock me one bit if the trial was "corrupted"."

Since Gonzalez is still promoting his failed protocol, I am pretty convinced he is corrupt. And, yes, I can still believe you work for him. For all I know you have designed a new zapper. But the fact that you resorted to allcaps screaming, strange formatting and total ignorance of HTML makes me even doubt you are an electrical engineer. All you have to do gain some credibility is post some real evidence.

Chemmomo:
If you are licensed, then you are approved by somebody. If you have a driver's license, you are approved by the DMV.

Chris: How can anyone take you seriously when you consistently slander people instead of making your case with class. Didn't they teach you this in debating class?
You also are not reading what I write:
"Wouldn't it be great to see a debate by prominent scientists on the benefit, or no benefit, of coffee enemas, and on the benefit, or no benefit, of ingesting pig pancreatic enzyme pills."
Notice how I said "debate" and "prominent scientists"
The links that you've provided me with only show that there was a trial, which appeared to be flawed, and it indicated that Gonzalez' regimen performed no better than no treatment at all. For me, the jury is still out on this trial and for Gonzalez. But if I was the Gonzalez patient with melanoma that I spoke to, or one of the 3 or 4 that posted earlier, I would have no doubt about him, would you?
Regarding your studies on the "dangers" of coffee enemas, it's crap to me. If you do them right and don't overdo them, they are no danger. Also, one of your "buddies" posted that it was indeed in the Merck Medical Manual years ago. You can hurt yourself or kill yourself doing any emema. Case closed.
Does it help the liver eliminate toxins? Case open...no proof it does help or it doesn't help.
Once again, I will ask:
Why would Gonzalez agree to do this study if he knew that his program was bogus? That would amount to business suicide, no?
You can choose to believe anything you want. I personally don't care. I would imagine that the 3 or 4 that posted here that were treated by Gonzalez don't care if you believe them either, as long as they remain cancer free.

None of us actually accused anyone of lying, simply being mistaken. Your oddly specific denial is suspicious.

Science doesn't work by debate, it works by observation. We see that coffee enemas cause far more harm than good, despite what some people believe, and we determine that they aren't worth the effort. Simple as that.

Also, why should we dismiss the idea of sorcery? Because it's "absurd?" You tell us we shouldn't dismiss coffee enemas (also absurd by many people's standards) out of hand, why should show any other ideas different treatment?

By Gray Falcon (not verified) on 23 Dec 2010 #permalink

Jake,
Never read, respond or even think about anything Chris ever posts. If you go back through 2 or 3 years of posts, you can see that Chris would argue with a wall just for the heck of it. Always churns out the same old supposed scientific crap over and over. You must ignore Chris completely.

Jake,

The links that you've provided me with only show that there was a trial, which appeared to be flawed

Please explain those flaws.

And having a license to manufacture a device does not mean that that said device is actually good for anything any more than having a driver's license means you'll obey all traffic laws and never cause an accident. You might want to review basic (pun intended) chemistry if you don't understand why Kangan water is utter nonsense (Hint: stomach acid is around pH = 1 to 2).

Gray Falcon:

None of us actually accused anyone of lying, simply being mistaken. Your oddly specific denial is suspicious.

Actually, yes, I did. Okay, I don't think Jake is really lying, but it is odd that he is defending Gonzalez so vehemently even after being presented with evidence. He can deny the evidence if he wants, but has yet to produce any independent evidence to refute it.

T.R.:

Always churns out the same old supposed scientific crap over and over.

Funny how that works. That is one thing I like about science, the rules don't change. And when science changes, actual evidence supports that change.

The same science is presented over and over, and then ignored, and in the return Jake has presented absolutely nothing. And who are you, and why should I care what you think?

@T.R. (199),

Actually, I think I'll apply your advice to you and Jake. I think that comes under the category of exemplifying the behavior you expect (or at least wish for) in others.

I actually enjoy reading Chris's comments because, at least when appropriate, she actually presents a coherent argument in favor of something.

That is, she does the following:

1. State what you believe to be true.

2. Present a logical chain of reasoning that leads to that conclusion.

3. Back up the major points of that chain with evidence that cross-checked and evaluated.

And, she has a lot more persistence than I do in trying to respond to people who can only answer with rhetorical dodgeball.

Happy Holidays to Chris and my other Insolent Acquaintances!

By squirrelelite (not verified) on 23 Dec 2010 #permalink

Oops!

3. should have been "evidence that can be cross-checked and evaluated".

By squirrelelite (not verified) on 23 Dec 2010 #permalink

Thank you, and Happy Holidays to you! We are finally decorating our tree. By the way, it turns out there is another "Chris" tonight... I have not commented on the modern Copernicus thread.

Always churns out the same old supposed scientific crap over and over.

...as opposed to the Alties churning out the same old non-scientific crap over and over?

That was just too easy.

By T. Bruce McNeely (not verified) on 02 Jan 2011 #permalink

Jake:

Interesting piece in JCO:

That is just a hand waving commentary on a study. Here is another commentary on the same paper.

Let's make this simple: find out what exactly the benefits versus the risks are for coffee enemas.

Go to the medical literature in PubMed and find something that shows a benefit from coffee enemas that is not from the Gerson Institute or any author associated with Gonzalez/Gerson/Kelly cancer treatment. Then come back with some real answers.

Oops, and now I realized I only read half of what Levine wrote!

Even if Gonzalez's criticism of Dateline's coverage were correct, Jake, what would that matter? Dateline is hardly the only party who's criticized Gonzalez's protocol; in fact, you're the first person to even mention it! Why do you feel the need to change the subject?

By Antaeus Feldspar (not verified) on 23 Mar 2011 #permalink

@210

I wonder if your errant "citation" would fall under a variant of Scopie's law?

And, looking at that link you posted, the amount of stupid posted on there would give most people a migrane.

ANTAEUS: The subject is Nicholas Gonzalez, correct? The point was how Dr. Gonzalez' treatment gets an unfair judgement. So much of the show displaying the opinions of a non MD from Sloan Kettering...a real expert, and another "expert", Andrew Weil!!! Give me a break. Meanwhile the MD that did the job of investigating Gonzalez years ago and found his treatment to be "of value" (my words) got a cameo. But the big star was the woman who did the hair testing. I guess the sensational wins out over the substance!! Really ridiculous.
NOVALOX: You missed the point. Go back to High School!!

Jake, I repeat:

Go to the medical literature in PubMed and find something that shows a benefit from coffee enemas that is not from the Gerson Institute or any author associated with Gonzalez/Gerson/Kelly cancer treatment. Then come back with some real answers.

So you took two months and came back with a link to an actor's website? How is that medical literature? How does that show there is a benefit to consuming coffee the wrong way around?

Chris,
As someone said a while back, you seem to have a fascination with the coffee enemas. Why don't you just try them and report back to us??? :)
Anyway, I have not seen anything to lead me to believe that coffee enemas are beneficial or not beneficial.
Back to the show: Why did the MD that investigated Gonzalez and gave him a "thumbs up" (my words) get such a tiny part??
Rather than relying on him, they relied on a PhD, doctor of sociology as an expert...what a joke. As I said before, why is Gonzalez not shut down????? Gerson was, as were many others, but he has not. When you do the enemas, I heard that Colombian grown coffee works better!!!! :)

Failure to answer questions duly noted. Now go up to the top of this two year old article and read about thetrial comparing methods, where those on the Gonzalez/Gerson/Kelly protocol did worse (there is a link early in the article, with links to several commentaries about it). They both died quicker and in more pain. Its authors are not just sociologists.

The reason Gonzalez is not shut down is that there is a flaw in the system due to the liberties granted to living in the USA. Deal with it.

While you are at it here a pair of books to help you understand the limits:
Charlatan by Pope Brock, with that you can understand why quacks are so hard to shut down
and
Emperor of All Maladies, about cancer.

With those books most of your answers will be found, and hopefully you'll find a better hobby than being necromancer on an old thread.

@213

Was that supposed to be an insult? Because that was as weak as they come.

I guess with the way you post, I wouldn't expect much intelligence from you.

Chris:
I did answer the question about your favorite activity...the coffee enema. I said:
"I have not seen anything to lead me to believe that coffee enemas are beneficial or not beneficial."
What else do you want?
As far as why Gonzalez is not shut down, I don't buy your answer. Nobody can put him in the same class as snake oil salesmen. He had an oncologist investigate him years ago and the oncologist came away impressed enough that he said that there is a place for him in treating cancer...that's quite an endorsement. This was mentioned briefly on dateline. As I mentioned in another post, I've spoken to two of his patients, and they both had nothing but great things to say about the man.

Chris & Jake:
I can't believe you two engineers are still arguing about medical procedure and research. As a retired research scientist, I can give you a little advice: DON'T believe everything you read in a scientific journal. Studies are often flawed and theories are constantly evolving. Part of the beauty of science is that our peers can suggest ideas that fly in the face of our results, test them, and expand knowledge. It is not a perfect system, but the best we have right now. The Chabot/Gonzalez study has flaws, so be wary of drawing any conclusions one way or the other. Just as an aside, trials such as this one will have gone through different "stages", such as animal model testing, before human testing is approved. This suggests to me that there must have been reasonable evidence that Gonzalez's method had potential before human patients were put at risk. From my perspective, another study is warranted in which ALL patients are pre-screened for willingness/ability to try either treatment protocol. This may seem like bias, but the results will tell you if a willing & able cancer patient does better with Gonzalez's protocol or conventional chemo.

Sure, Sidney. Anything you say, Sidney.

Do you mind telling us why another study is needed? It has already been shown that Gonzalez's patients die quicker and with less quality of life. The getting coffee directly through the colon is guaranteed to put a stress on their liver, and to keep them from getting the healing rest they need. The hair diagnostic tests are pure fantasy, so there isn't any science there to even study.

Can you tell us exactly why we should care about what Dr. Gonzalez says when he sends hair samples to a woman who uses a DelaWarr radionics machine, that operates not on electricity but "intuition"?

Just as an aside, trials such as this one will have gone through different "stages", such as animal model testing, before human testing is approved. This suggests to me that there must have been reasonable evidence that Gonzalez's method had potential before human patients were put at risk.

Should have been. Wasn't.

I totally agree with Sidney. Another trial is needed. And, it needs to be comprised of patients with the same stage of disease who are willing and able to comply with either treatment protocol. It is THE ONLY WAY to determine which protocol is superior. As long as there is room for Gonzalez and his proponents to argue that the current results are skewed because many patients were unable to comply with his protocol, we will never know the answer. And, it's a legitimate argument. To those who argue that his treatment is inhumane and leads to patient suffering, I say let the patients decide. If, after being fully informed, they agree to his protocol, then so be it. Any patient always has the option to drop out of a trial if they so desire. Is Dr. Gonzalez's protocol equal to or better than conventional chemotherapy? I have no idea. But, why be afraid to find out?

The protocol is already doomed and useless if such a small fraction of patients can follow it, even if it worked for them. Which the evidence indicates it doesn't. And there's no basic science or preclinical studies suggesting otherwise.

Another study would be almost as unethical as Tuskegee at this point. We know the protocol kills for no plausible benefit. The ONLY way it could possibly become credible to even consider another study would be if Gonzalez went back to the beginning and actually did the basic science and preclinical work, and it were sufficiently positive to outweigh the existing evidence.

Beamup - you and others are ready to dismiss Gonzalez and his work (along with the work of his predecessors) without any more evidence than a flawed trial. As I said earlier, why be afraid to find out if Gonzalez's protocol is more than snake oil? How can it be unethical to give patients an informed choice? And, what do we say to the patients already treated by Gonzalez and who have responded well to his therapy? Do we tell them it was pure luck that their results were much better than conventional therapy could deliver?
Maybe it was pure luck. But if I have stage 4 pancreatic cancer, I'll take that chance because with conventional treatment, I doubt I'll be around in 6 months to argue. As to your suggestion that Gonzalez go back and to the pre-clinical work, you may not be familiar with the work of Dr. William Donald Kelley who documented the treatment of thousands of cancer patients, and on whose work, Dr. Gonzalez's subsequent work and protocal is based. While completing his fellowship in cancer, immunology and bone marrow transplantation at Sloan-Kettering, Dr. Gonzalez put together a tome detailing the case histories of 50 patients diagnosed with late stage cancers still alive 15 years later and whose survival was attributed to Kelley's program. Interestingly, Gonzalez couldn't get the findings published in the medical journals, and apparently not because they lacked substance or validity. Dr. Robert Good, president of Sloan-Kettering (nominated for the Nobel prize 3 times) and also Gonzalez's mentor, was also unable to get the findings published (even though he had already published over 2000 articles). I would think most physicians would love to read about a patient or two with advanced pancreatic cancer alive after 15 years. And these guys had documented histories of numerous patients still alive. Yet, they couldn't get the cases published. The results were dismissed out of hand as quackery. Yet, everything Dr. Good had done to that point was highly regarded, including doing the very first bone marrow transplant.
Lastly, to your point that even if Gonzalez's protocol works, it is doomed and useless if it is only appropriate for a small portion of the total patient poplulation (I hope I have interpreted your comment correctly), this is unequivocally not true. We segment patients all the time for different treatements based on degree and characteristics of disease. IF the Gonzalez protocol is effacacious and IF it only works for a small percentage of patients with particular disease characteristics (e.g. 10-30%), I have no doubt that all those stricken with the disease will pray they are in that small percentage rather than roll the dice with conventional treatment.
I ask again, why be so afraid to find out? Unless you work for Lily, what have you got to lose?

you and others are ready to dismiss Gonzalez and his work (along with the work of his predecessors) without any more evidence than a flawed trial. As I said earlier, why be afraid to find out if Gonzalez's protocol is more than snake oil?

The flaws aren't significant enough to reverse the results. Coupled with the lack of reason to consider it plausible, a provisional rejection is the only logical conclusion.

As I said earlier, IF the proper groundwork were laid, and that groundwork was sufficiently compelling to offset these results, then it would be reasonable to revisit it.

How can it be unethical to give patients an informed choice?

You're not advocating "an informed choice." You're advocating more trials. Which are unethical because (a) Gonzalez does not provide an informed choice, (b) accepted clinical trial ethics require that there be proper preclinical foundation before subjecting patients to risk in the course of a study, (c) the evidence currently suggests that the treatment is not just useless but counterproductive.

And, what do we say to the patients already treated by Gonzalez and who have responded well to his therapy? Do we tell them it was pure luck that their results were much better than conventional therapy could deliver?

First, one would have to demonstrate that such patients actually existed. And if they did, then yes, that would be the true thing to tell them.

For the rest of your supposed points, read the original post and those linked from it. Been done over ad nauseum.

As I said earlier, why be afraid to find out if Gonzalez's protocol is more than snake oil?

Because the balance of the evidence available to date says that some people will probably die in more pain than necessary if another trial is performed, with no clear evidence that any will be helped. Simple as that. If you care more about having a point proven than you do about patients' welfare, then perhaps that doesn't matter to you.

There are a great many things which *might* be true but which we do not study. We do not study whether flapping your arms vigorously will save your life if you jump out of an airplane without a parachute, for instance, because the evidence is overwhelmingly against it working and so we're pretty sure people will die if we are so stubborn we have to have a double-blind controlled trial before we'll admit we don't actually have any positive evidence. Now, the Gonzalez Protocol is not as ridiculous as trying to fly when you leap out of an airplane, but not much. One might compare it to an untrained person attempting to fly out of an airplane using a wingsuit and landing on a specially prepared ramp. (There is a guy preparing to attempt such a feat. It has never been done, and there is considerable suspicion that he will become a long buttery smear down the ramp, though if anyone can do it, it's him. He's far from untrained, though.)

How can it be unethical to give patients an informed choice?

It's not, but you're not really proposing an informed choice. You want to present the Gonzalez Protocol as just as plausible, based on the current state of the evidence, as existing chemotherapeutic regimens, and that is not what the current state of the evidence says. You cannot just pretend that trial never happened. You'd have to disclose that it happened, was unfavorable, and that the purpose of the current trial is to collect more evidence. But given that the Gonzalez trial was halted because it was failing to help, I think you'll have a tough time recruiting if you're really honest about the state of the evidence.

By Calli Arcale (not verified) on 26 Apr 2011 #permalink

Dr Nicholas Gonzalez is a contraversial figure because anyone who decides not to worship at the sacred cow of modern medicine, ie, drugs and more drugs, will be considered a threat.
My husband was a patient of Dr. G. This doctor is brilliant, unusually energetic (as he follows he own advice), compassionate, and OPEN-MINDED.
The pharmaceutical industry seems largely greed-driven. It's long arm of influence is felt in medical schools and doctor's offices. If they can't patent it, then they aren't interested. Follow the money.
The modern medical industry seems incapable of investigating anything that lands outside the self-imposed small world in which they confine themselves. Should a mere layman dare to imply a world exists outside of their little box, they immediately rise up to villify and condemn. Meanwhile, hundreds and thousands are cured of cancer through a variety of modalities that fall outside the understanding of orthodox medicine.
Thank God for some freedom of the press..... for great books and the internet that allow us options that the medical world refuses to investigate with an open mind!! Thank God for brilliant doctors like Nicholas Gonzalez who with truth on their side are willing to face the ire of the medical establishment.

Why is your husband not posting about how much Dr. Gonzalez did for him? Not because he died after trying Gonzalez's treatment, surely.

As for "greed," how many charity cases does Gonzalez take, and how much does he charge the rest of his patients? (When I was in an emergency room a few years ago, one of the forms I was given was instructions on how to apply for charity care if I didn't have insurance.)

By Vicki, Chief A… (not verified) on 23 Jun 2011 #permalink

"Dr Nicholas Gonzalez is a contraversial figure because anyone who decides not to worship at the sacred cow of modern medicine, ie, drugs and more drugs, will be considered a threat."

Given that this would include nearly all of the professions allied to medicine and all the allied health professions, as well as significant portions of the main medical community itself, we can safely say that this is a made up reason with no basis in reality or observable facts.

@Martha:

Meanwhile, hundreds and thousands are cured of cancer through a variety of modalities that fall outside the understanding of orthodox medicine.

Obligatory [citation needed] is obligatory.

All of these controversies would be eliminated if there were less expensive ways to test for efficacy of therapies.

We can imagine a future where nano-devices can be implanted in tumors to test, in real time, for apoptosis, angiogenesis, metastasis rate, etc. Then we could test, in real time, anything from shark liver oil to hemp oil for efficacy.

Better, less expensive, testing methods should be our top priority. We should abandon the antiquated FDA testing rules that are dominated by Big Pharma. We could test for many things that we don't test for now because the testing process is far to expensive, long and poorly regulated.

Since we have a large pool of terminally ill cancer patients who are condemned to die within a few months, qualified medical practitioners should be allowed to test a wide array of possible cures within a set of legal constraints which have been debated elsewhere and for a long time.

The legal/ethical debate bottleneck is surely the biggest problem. Until we solve it, desperate people will be left to grasping at straws.

Criticizing doctors like Dr. Gonazalez is probably futile given the history of science and all the persecutions and prosecutions of scientists who have given us our greatest scientific discoveries, from Galileo and Giordano Bruno to Louis Pasteur and Linus Pauling.

If they can be shown to be hypocrites and liars whose goal is to make money from dying people then they should be put in jail. Otherwise, they are simply benighted, deluded scientists who are trying desperately to help desperate people.

James Street:

Criticizing doctors like Dr. Gonazalez is probably futile given the history of science and all the persecutions and prosecutions of scientists who have given us our greatest scientific discoveries, from Galileo and Giordano Bruno to Louis Pasteur and Linus Pauling.

Ah, the Galileo Gambit! Except the difference was that they were correct (well, except Pauling when it came to Vitamin C).

One reason we know Gonzalez is wrong is that his protocol was tested, and it failed. And yes, he is a hypocrite and lying. He should lose his license to practice medicine for both advocating coffee enemas and paying a woman at a spa to analyze hair samples by intuition (the DelaWarr radionics machine).

If you have any real science that shows coffee enemas are beneficial and do not put stress on the liver, plus keep patients awake when they should be resting, please present it. If you have any real science that a machine that uses no electricity and works on intuition is a valid diagnostic tool, then present. Until then, keep your idle speculations to yourself.

The unnecessarily vicious tone of your comments and the personal attacks totally derail whatever it is your are arguing. You do not need to insult Gonzalez to argue that his methodology is ineffective. Learn some manners!

George, anyone who thinks the DelaWarr radionics machine is a valid medical diagnostics device deserves to be mocked. Especially if he promotes torturing sick people with coffee enemas and hastens their deaths.

The data showed his methodology was ineffective. His treatment and disregard for his both the data and the patients makes him deplorable.

George, learn to understand the evidence!

You do not need to insult Gonzalez to argue that his methodology is ineffective.

No we don't, but a bonus is a bonus.

The unnecessarily vicious tone of your comments and the personal attacks totally derail whatever it is your are arguing. You do not need to insult Gonzalez to argue that his methodology is ineffective. Learn some manners!

Does it really derail it? Are you incapable of reading for content and unable to ignore tone? That seems like a personal problem you might want to deal with.

One can argue that there is perhaps a problem with ridicule and tone when it comes to convincing some people. There are people such as yourself who apparently turn off when they read something biting and less than codling and refuse to address the arguments that are present. However, how correct the argument is really has nothing to do with the tone and how nice it is. But there are others that learn from it, that need someone to take a harsh tone to snap them out of their mistaken thoughts. It is also just really enjoyable to write like that and to read it. I get a kick out of it.

@ Travis: Interesting, as I seem to recall that many critiques of SBM ( e.g. Mike Adams' new article on Swine Flu Vax) seem to use invective rather freely, albeit clumsily. You would think that by now supporters of woo would be rather inured to nastiness.

By Denice Walter (not verified) on 09 Oct 2011 #permalink

Since my comment was the one just before George's, I would like him to tell me exactly what was particularly vicious about it. I first note that the Galileo Gambit was employed, then explain that Dr. Gonzalez's protocol was tested and it failed, followed up by a request for data that shows that there is evidence for the validity of some parts of the protocol.

Do tell, George, how my tone was vicious. Be particular about which phrase qualified for your pointed critique.

Denice Walter,
Perhaps they hold science based medicine proponents to a different standard as they realize that behind our arguments there normally is a logical, careful evaluation of evidence whereas they really only have the anger, accusations, vitriol and generally made up stuff. We could drop biting attacks and there would still be content. If they were to drop it there would be nothing left.

I have no bias as to whether Dr. Gonzalez's works or not, I would only like to know the trueth as my wife (30yrs old) has undergone a mastectomy, chemo and radiation. She has read Suzanne Somers' book along with some other and is scared sick that she made the wrong choice. As a forensic auditor I am trained in statistical analysis and non-biased sampling probably more than most medical scientists. The problem with this entire situation is that it was doomed to fail from the beginning because of bias. Dr's from both sides of the experiment were too closely involved in the set up of the trial and the interpretation of results, leaving a reasonable observer of the findings to question the objectivity of the experiment. If there is ever to be an answer to the claims of Dr. Gonzalez then the only way to do this is to set up a true trial which should be supervised by a non medical body. I would suggest the following format

1) Have a mutually agreed upon testing procedure and protocol by Dr G. and the Chemo side
2) Let Dr G select all patients for the test and then have them randomly split in to the two groups. Dr G will not know which of the sample population will be receiving his treatement. Now we are comparing aples to aples. (the patients must know in advance what they are signing up for and be willing participants, unlike before)
3)Treatement is administered by Dr. Gonzalez himself and the best chemo Dr possible

Now we've removed all the "what if's" and it is a fair test. Results will stand irrefutable and everyone can move on.

This is what I think anyways.

Ken,
Since the results of the clinical trial discussed here were so clear cut, I think it is very unlikely that the trial you suggest will ever happen. It would be unethical to offer any patients a treatment that is so much less effective than conventional treatment.

Since you are an expert in non-biased sampling, I assume you are suggesting that selection bias might have been responsible for the results of this trial.

At enrollment, the treatment groups had no statistically significant differences in patient characteristics, pathology, quality of life, or clinically meaningful laboratory values. Kaplan-Meier analysis found a 9.7-month difference in median survival between the chemotherapy group (median survival, 14 months) and enzyme treatment groups (median survival, 4.3 months) and found an adjusted-mortality hazard ratio of the enzyme group compared with the chemotherapy group of 6.96 (P less than .001). At 1 year, 56% of chemotherapy-group patients were alive, and 16% of enzyme-therapy patients were alive. The quality of life ratings were better in the chemotherapy group than in the enzyme-treated group (P less than .01).

It is a remarkable kind of selection bias that does not affect "patient characteristics, pathology, quality of life, or clinically meaningful laboratory values", yet results in an adjusted-mortality hazard ratio of nearly 7.

By Krebiozen (not verified) on 18 Nov 2011 #permalink

Now we've removed all the "what if's" and it is a fair test. Results will stand irrefutable and everyone can move on.

This is what I think anyways.

The woo brigade will not move on. They would find some way to invalidate the test you propose and claim that their treatment does work, it just hasn't been studied appropriately.

I am sorry to hear about your wife's cancer. It's awful to have to face this at any age, let alone at 30 years old. I hope her treatment is successful.

You both may find this article to be helpful.

Thank you both for your comments (I sincerely mean that). I respect what you have said a great deal. I don't mean to sound like I disagree with you because I don't, I just wonder if the test was appropriately designed to analyze the claims of Dr G's therapy. Basically, I am still left with questions.

I've read his part in Suzanne Somer's book (which I neither support nor oppose -but let me at least say that I have my concerns about it's accuracy). But what I read was that Dr G himself claimed that his treatment wouldn't work on some patients (with eating problems etc). So the only question I have remaining is whether the test parameters were adequately set up to analyze the treatment success of Dr. G's regime.

It is obvious that the original test results were cut and dry but I am still left wondering (as an objective by-stander) if it really tested what it was meant to test, which was to see if, based on Dr. G's ideal patients, his treatement would work better than conventional medicine. Because even if his treatement will only work on a very specific type of person that is at least better than nothing and the people that fall in to that category could benefit from it.

It would be like someone claiming that red-heads living under power lines have a higher likelihood of getting cancer and then testing the general public (all hair colors) and say that there is no evidence that living under a power line significantly increases the likelihood of cancer.(I realize the analogy is stupid but I think it gets my point accross)

Again, I am not supporting Dr G but I am left wondering if the trial really tested his claims.

TBruce,

I tried the link to the article but it didn't work. Could you try and send it again? I would really like to read it and any other materials you have on the issue. It seems like all books and articles these days are the ones about why mainstream medicine is not working. I would like to balance out the arguments by hearing more from the other side.

I tried the link to the article but it didn't work.

Delete the " rel=" at the end if you want to follow it.

Ken,
This blog is a great resource for accurate information about the relative merits of conventional and alternative medicine. This website is also a very valuable resource.

Your wife has sensibly chosen the treatment that offers her the very best chance of a full recovery. I am disgusted that people like Suzanne Somers spread disinformation that leads people to make foolish and life-threatening decisions. I am glad that your wife was not exposed to this nonsense before she decided what course of treatment to accept, but sad and angry that she has been made to feel "scared sick that she made the wrong choice". She hasn't, and I hope she makes a rapid and complete recovery.

By the way, it seems very likely that Somers suppressed her immune system by taking "bioidentical cortisol replacement therapy", leaving her vulnerable to disseminated coccidioidomycosis which nearly killed her. I wouldn't take medical advice from a person who doesn't know that cortisol, bioidentical or not, is a steroid hormone. If you search for her name using the search box on the left of this page you will find plenty of information about Somers and her book.

By Krebiozen (not verified) on 19 Nov 2011 #permalink

insolent, yes. but neither respectful nor truthful.

By Jane Richard (not verified) on 22 Jan 2012 #permalink

@jane richard

Any reason to necro a thread, idiot?

@ novalox:

"Any reason to necro a thread, idiot?"

I dunno, perhaps because Jane is having a boring day and is shilling for Big Coffee.