Hallwang Private Oncology Clinic

The deadly false hope of German cancer clinics, part 2: Metastasizing to Australia and beyond

oracknows — Wed, 09 Nov 2016 07:00:26 +0000

The deadly false hope of German cancer clinics, part 2: Metastasizing to Australia and beyond

Yesterday, I wrote about alternative medicine clinics in Germany that offer a combination of alternative cancer cures plus experimental therapeutics administered improperly outside the auspices of a clinical trial. In particular, I discussed two cases. The first was British actress Leah Bracknell, who is raising money to go to one of these alternative cancer clinics to treat her stage IV lung cancer. the second was a British woman named Pauline Gahan, who was diagnosed with metastatic stomach cancer and has thus far spent £300,000 for a combination of vitamin infusions, “detox,” and Keytruda (generic name: pembrolizumab). This is a drug belonging to a new class of promising anticancer therapies known as immune checkpoint inhibitors. It’s FDA-approved for some cancers, but hasn’t yet been shown to be effective against stomach cancer, although there is one phase I trial that is promising and thought to be sufficient evidence to justify phase II and III trials. None of this stopped the clinic to which both Bracknell and Gahan traveled, the Hallwang Private Oncology Clinic.

One thing I noticed about the Hallwang Private Oncology Clinic when I wrote about it is that nowhere did it list the doctors who own and operate it or who consult there. I did find one name, Dr. Jens Nolting, mentioned on patient discussion boards as working at Hallwang. The lack of mention of who runs the clinic and who practices there was an enormous red flag to me, I think for obvious reasons. Fortunately, a reader with more knowledge than I and thus a better idea of what to Google for, pointed me in the right direction. So I thought I’d do a follow-up post and then segue to a report that aired on Australian TV on alternative medicine for cancer there to show the consequences of clinics like this, which are, unfortunately, a problem in many advanced countries. Thus, this post might be a bit “odds and ends”-ish, but it’s a topic that’s been of intense interest to me ever since I discovered the depths of alternative medicine applied to cancer, and I didn’t want to leave last week’s post, in essence, unfinished. Also, there is at least one interesting connection that I hadn’t realized as I wrote my post yesterday.

Ursula Jacobs and Farrah Fawcett

The key bit of information that I didn’t know when searching for who owns Hallwang Private Oncology Clinic was that it used to be known as the Private Clinic of Dr Ursula Jacob, a name change that occurred in 2014. She also apparently has a clinic known as the Day Clinic for Prevention and Regeneration. Her CV shows an early career that appeared rather conventional. She studied medicine at the Semmelweis University in Budapest from 1985-1991, trained in general medicine and family practice from 1991-1995. Then things went wrong, as she took a job at Leonardis Klinik in Kornwestheim in internal medicine and hematology from 1995-2000, becoming senior physician there in 1997. You might recall that Leonardis Klinik was—apparently it’s closed now—one of the premiere German alternative cancer clinics.

In fact, the Leonardis Klinik sounded very familiar to me, as did the name Ursula Jacob. I thought and thought, trying to remember, and then I decided to see if I’ve ever written about either before, either here or at my not-so-super-secret other blog. Guess what? Back in 2009, Dr. Ursula Jacob, who by then had started working at another German alternative cancer clinic, Klinik-Alpenpark, treated Farrah Fawcett with “vitamin preparations that she says boost the immune system.” She was also treated at Leonardis Klinik. She also underwent treatment that is not alternative but was probably not appropriate for her, chemoembolization.

Towards the end of her life, Fawcett became disillusioned with the German alternative medicine clinics that she had trusted, as shown in a documentary that she made about her cancer diagnosis and treatment, Farrah’s Story. As I’ve described before, Fawcett was diagnosed with anal cancer. She underwent what sounds like the standard chemoradiation protocol known as the Nigro Protocol. Unfortunately, she recurred locally at the anus, and the only treatment for a local recurrence of anal cancer after the Nigro Protocol is an operation known as an abdominoperineal resection (APR), in which the rectum and anus are removed, the hole sewn shut, and the patient left with a permanent colostomy. Not surprisingly, Fawcett didn’t want that. (No one does.) Unfortunately, she heard the siren call of the German alternative cancer clinics, which were doing the same thing then as they are now, combining experimental treatments with pure quackery:

Instead, she opted to put herself under the care of two German specialists, Professor Thomas Vogl and Dr Ursula Jacob.

Mrs Stewart said: 'She believed it would be less drastic.'

Professor Vogl, 50, who practises in Frankfurt, offers cancer patients a treatment called chemoembolisation, during which chemicals are injected directly into organs at a cost of £3,500 a session.

During filming, Miss Fawcett was shown groaning and writhing in pain as a long needle was thrust into her liver by Professor Vogl.

She also underwent a surgical procedure called laser ablation, which heats up the tumour to around 38C (100F) to destroy cancer cells.

Professor Vogl later assured Miss Fawcett that all the 'active tumours' had been removed, while Dr Jacob, who uses vitamins to boost the immune system at her Alpenpark Clinic in the Bavarian Alps, claimed it was a 'miracle'.

However, just a few weeks later, Miss Fawcett underwent a scan that showed the original tumour was larger than ever and that the cancer had spread to her liver.

Chemoembolization is a legitimate treatment for liver tumors, as is laser ablation. Basically, chemoembolization involves injecting chemotherapy and small synthetic particles directly into the hepatic artery. The chemotherapy attacks the cancer, and the particles embolize (travel along the artery) until they lodge and block the blood flow to the tumor. Similarly, this laser ablation sounds like nothing more than a fancy version of thermal ablation of tumors that uses laser instead of radiofrequency waves to generate the heat. Although these treatments can be palliative, it is very uncommon for them to be curative; so it is not at all surprising that Fawcett’s tumors came roaring back. As for the “immune boosting vitamins” administered by Dr. Jacob, there’s no good evidence that such treatments do anything at all other than to produce expensive urine.

Not surprisingly, both Dr. Jacob and her apologists are quick to blame anything other than her treatments for Farrah Fawcett’s death. First, here’s what Dr. Jacob said:

I asked Dr. Jacob where Farrah went wrong in her cancer treatment. She replied that when Farrah returned to the United States, she went back to receiving high-dose chemotherapy.

Dr. Jacob doesn't like chemo because it's so toxic. If she uses chemo at all, she only uses it in low doses -- about one tenth of the amount that conventional cancer doctors give. And she sometimes recommends chemo-embolization, as she did in Farrah's case.

Dr. Jacob considers chemo a bad idea unless a chemo sensitivity test is used to match a patient's cancer cells to the chemotherapy drug that's most likely to kill them. The test indicates that a specific kind of chemo will work, and thereby avoids the hit-or-miss approach of conventional cancer doctors, who will administer one chemotherapy drug after another (in high doses, of course), hoping to find one that works.

If a chemo sensitivity test shows that no chemo is likely to work against a particular cancer, Dr. Jacob says NO chemo should be used.

Chemosensitivity tests of the sort that Dr. Jacob advocates are not generally used because their predictive value has not been validated and when tested, in general has not been very good. These sorts of tests are very old, dating back almost to the dawn of chemotherapy for cancer. That’s why the American Society of Clinical Oncology (ASCO) concluded in 2011 that in vitro chemosensitivity testing has promise but should only be used as part of clinical trials, the same conclusion it came to in 2004. Moreover, given the advances in genomic testing, chemosensitivity testing is downright quaint and difficult to do.

Dr. Jacob also blamed stress for Fawcett’s death:

Dr. Jacob also reminded me about another factor that contributed to Farrah's death: the stress of a family crisis. During her struggle against cancer, Farrah's 25-year-old son, Redmond, got in trouble with the law. He was put behind bars on April 5, 2009, two months before she died, for a drug offense.

And Andrew Scholberg blames—of course!—sugar:

Unfortunately, Farrah had a weakness for Coca-Cola, which is jam-packed with sugar. Coke was Farrah's favorite beverage, as her best friend Alana Stewart noted in her diary entry for June 1, 2007. Even in the midst of her cancer treatments, Farrah couldn't stop drinking Coca-Cola. Believe it or not, each 12-ounce Coke contains an astounding 10 cubes of sugar! That's right. Drinking one Coke is like eating 10 sugar cubes.

Farrah's German medical team is not to blame for her death. In fact, they helped Farrah extend her life and gave her a better quality of life. My reporting points to at least three factors beyond the control of Farrah's German doctors that contributed to Farrah's death:

Her addiction to sugar

Stress from her son's drug conviction and incarceration

Her decision to revert to high-dose chemo, a toxic treatment

Sugar does not “feed” cancer. That is a myth.

Of course, Farrah Fawcett’s death was not the fault of alternative medicine or the doctors who administer it. Deaths like hers never are. The bottom line is that, unfortunately, Farrah Fawcett’s best chance of surviving her cancer was to undergo APR. It’s a horrible choice. No one wants a permanent colostomy, but I’ve taken care of a number of patients over the years who’ve had one. It is quite possible to live a fulfilling life with one. Once Fawcett declined that option, her odds of surviving her cancer plummeted dramatically. It was possible that local ablation of the tumor might have resulted in long term survival, but highly unlikely. The die was cast when Fawcett refused surgery.

Dr. Ursula Jacob today

So what is Dr. Jacob up to today? At her (apparently other) clinic’s website, she advertises a fairly standard variety of alternative medicine quackery (but I repeat myself), including detoxification and intestinal cleaning:

We offer individually designed examinations of the stool from which we can build an individual programme of detoxification, working on the colon and lymphatic system in order to repair the damaged systems and restore balance to the flora in the gut.

We’re talking enemas, of course. I’ve yet to see an “intestinal cleaning” and “detoxification” protocol that doesn’t involve enemas, coffee or saline.

Then there’s intermittent hypoxia:

Intermittent Hypoxia (sometimes known as ”Altitude Training”) is used to improve oxygen supply to the cells which can regenerate the brain and the body, used together with specific amino acids, the overall cell energy can be improved. This leads to better performance and a natural ”anti-aging”.

This is utter woo babble (like techno-babble in Star Trek, just with woo).

Then there’s boosting the immune system, the all-purpose (and vague) claim, beloved of quacks everywhere:

We carry out blood tests that can show how severely the individual systems are damaged from which we devise therapeutic treatment plans. We work with natural anti-inflammatory and immune complex-depleting substances, photopheresis and regenerative therapies.

Then there’s reflexology:

Reflexology, is a therapy involving the physical act of applying pressure to the feet with specific thumb, finger, and hand techniques without the use of oil or lotion. It is based on stimulating reflex areas that relate to the internal organs of the body which can improve the circulation, relieve stress and stimulate self-healing processes.

Or, as I like to call it, a foot massage with delusions of grandeur.

I think you get the idea. These German alternative medicine cancer clinics thrive based on the desperation of cancer patients with the means to travel to Germany or at least the means to raise the large sums of money required to travel to Germany and be treated at these clinics. Hallwang, run by Dr. Ursula Jacob, is just one of them.

The other quacks of Hallwang

Thanks to my reader, I also learned who else works at Hallwang. These doctors include:

Dr. Fatiha-Nora Mühe
Dr. Asir Kopic
Dr. Emina Kopic
Dr. Greg Schwarz

Oddly enough, there’s not much to be found online about these four doctors. Dr. Fatiha-Nora Mühe appears to be an internist.

Dr. Asir Kopic appears to be an oncologist, and has a website. That website lists him as the chief physician of Hallwang from 2012-2014, but not beyond. So it’s not clear whether he still practices at Hallwang. It is, of course, quite possible that he still consults at Hallwang, but now maintains his own Stuttgart private practice with what appears to be his wife, Dr. Emina Kopic, who is listed at the same website as an “orthomolecular therapist.” Remember that “orthomolecular medicine” is a form of quackery popularized by Nobel Prize winner Linus Pauling. The high dose vitamin C treatments that he advocated to treat everything from cancer to the common cold are basically part of orthomolecular medicine, which advocates superdoses of various nutrients to treat diseases. As I like to put it, in orthomolecular medicine, if some is good, more is always better.

I’ll get to Dr. Greg Schwarz in a minute. First, however, I can’t resist mentioning that my commenter pointed out that the website for the Hallwang Private Oncology Clinic is registered under the name of Dr Albert Schmierer, who is CEO of "Dr Zinsser Pharmaceuticals.” He’s described thusly:

Dr. Albert Schmierer is one of the leading German researchers in the field of cell mitochondrial as well as homeopathic treatments with a keen interest in anti-ageing medicine, including cell therapy with the emphasis in cell mitochondrial treatment for rejuvenation, regeneration and fighting premature ageing. He is also the chief pharmacist for mitochondrial and homeopathic therapy at the Private Hospital Dr Ursula Jacob GmbH as well as the owner and CEO of Dr Zinsser Pharmaceuticals.

More woo babble. Not surprisingly, Dr. Jacob is also featured prominently on the company website. But what does this company actually make and sell? It appears to be mostly anti-aging products:

ZÉLL-V started its operations in 2007 with the mission to enable every individual to enjoy a healthy, vibrant, beautiful and quality life. As the process of ageing remains untreatable with conventional medicine, ZÉLL-V aims to defy ageing by harnessing the body's own healing and revitalising power through cellular therapy.

With this, ZÉLL-V has partnered with international medical experts to develop an exclusive formulation - the most advanced cellular therapy to activate cellular repair and regeneration through the use of cutting-edge biotechnology.

Obviously, this is more woo babble, but what does it mean, if anything? It means “live cell therapy,” which, translated, basically means grinding up animal glands and injecting them:

Cellular therapy is a complete biological treatment using fresh cells or cell factors to stimulate intra-cellular repair mechanisms and cell rejuvenation and regeneration, thereby slowing down the natural process of ageing and counteracting chronic degenerative diseases.

Cellular therapy was discovered by Professor Dr Niehans by chance in 1931 when he saved a woman writhing with convulsions after an operation on her thyroid gland by injecting her with a suspension of animal parathyroid glands - an unknown treatment at that time.

The woman went on to live another 30 years, well into her 90s. Later, at his clinic in Montreaux, Switzerland, Professor Dr Niehans went on to administer live cell injections to thousands and thousands of patients, including many of the crowned heads, presidents, Pope Pius XII and numerous Hollywood stars.

Today, ZÉLL-V cellular therapy is widely used across the globe. Possessing limitless potential to restore people's health, youth and quality of life, cellular therapy is touted as the future of medicine and health maintenance.

The example of Paul Niehans injecting parathyroid glands is a highly dubious story. It’s not that it’s all that implausible on one level. After all, the hormone made by parathyroid glands (parathormone or parathyroid hormone, abbreviated PTH) is critical for regulating calcium levels in the blood. Indeed, severe hypocalcemia (low calcium) is a known complication of total thyroidectomy because the parathyroid glands are intimately associated with the thyroid gland. If all four of them are injured or accidentally removed with the thyroid, potentially fatal hypoparathyroidism can result. That’s why a common practice is to remove one or more of the parathyroids, mince them, and implant them into a skeletal muscle, a practice known as parathyroid autotransplantation. The cells survive, thanks to the blood supply of the muscle, and keep producing parathormone. The story above is, of course, nonsense, as a quick look at even Wikipedia will tell you, as the function of the parathyroid glands was known as 1908.

In any case, live cell therapy is basically a quack treatment based on the concept that there is some sort of “essence” in various animal cells that can rejuvenate and repair human tissue, as described here:

In order for this to happen, ZÉLL-V Cellular Therapy supplies the human body with young and active cellular material obtained from sheep embryonic or early foetal cells and placenta. These active cellular materials are young and full of vitality, as such, once taken into the body, they are able to imprint their vigour upon the body's weak and old cells, thereby 'teaching' them to regenerate themselves, resulting in an overall improvement and restoration of our bodily systems.

Even more ridiculously, these animal organs and glands are often produced in pill form, to be consumed rather than injected, so that, even if there were something in the cells that could affect human physiology, chances are that it would be destroyed by the digestive tract. Quackwatch, of course, has an excellent discussion of live cell therapy and why it is quackery. It’s also not safe. There have been reports of fatal immunological reactions, gangrene at the site of injection of sheep cells, and other problems.

None of that stops Zéll-V from selling sheep placenta pills for up to $1,920 a package and claiming all manner of health benefits. I was, however, amused to learn that there are organizations called the German Society for Thymus Therapy and the International Association for Organ Therapy Specialists Switzerland and Germany.

So, regardless if all of the doctors I’ve discussed up to now still practice at Hallwang, there is no doubt that, between Dr. Jacob and Dr. Schmierer, Hallwang Private Oncology Clinic still delivers the quackery.

The Australian connection

But wait. I’ve overlooked someone. Actually, no, I haven’t. What I did notice in my searches is that Dr. Greg Schwarz is no longer at Hallwang Private Oncology Clinic. In fact, he’s moved to Australia to join Gore Street Medical in South Hobart, where he is described as having “returned from working at a specialised cancer centre in Germany,” bringing “his expertise in nutritional medicine and environmental medicine to Gore St Medical” as well as this:

Dr Schwarz is a medical practitioner focussing on integrative health care, targeted, individualised, holistic therapies for complex, chronic medical problems including cancer, autoimmune conditions, inflammatory conditions, fatigue including ME/CFS/fibromyalgia, neurological conditions including autism and dementia support, gastro-intestinal conditions, allergies and food intolerances, recurrent and chronic infections, and general preventative health.

And what sort of therapies does Gore Street Medical offer? The usual. Here are just a few:

And, of course, there are iron and vitamin infusions and heavy metals chelation.

I was particularly amused by the woo babble in this video describing bioresonance:

Yep, it’s all about the “vibrations,” man. Basically, a machine determines the “bioenergetic” resonance of a compound suspected of causing problems and then determines if that’s what’s causing a patient’s symptoms. Yes, it’s basically a machine that goes ping, as in an expensive machine that doesn’t really do anything useful but sure looks impressive to the rubes.

In the end, the cancer quackery of the German alternative cancer clinics has produced a small metastasis to Australia in the form of Dr. Schwarz. How Gore Street Medical contributes to the problem is described in an excellent short report that aired a couple of weeks ago on Australia’s Science Channel:

Be it Germany, Mexico (where I happen to be chilling right now on vacation), Australia, or even the US, unfortunately cancer quackery is a problem everywhere. The German cancer clinics epitomize much of this problem, and there’s no sign that they’re going away any time soon. Patients not only end up undergoing ineffective treatment, they spend lots and lots of money doing it. I searched GoFundMe for Hallwang Private Oncology Clinic, and came up with five pages of patients trying to raise money to go to Hallwang. The GoFundMe pages had names like Saving Dad, Help Michelle’s Fight, Claires Medical Fund to Germany, Please Help My Mum Get Treatment!, and Hayley’s Cancer Treatment Fund.

As the Australian report above points out, conventional medical treatments must be supported with science and evidence from randomized clinical trials. As I pointed out yesterday, clinics like Hallwang rarely, if ever, publish their results, but that doesn’t stop them from taking advantage of the desperation of cancer patients by offering them false hope at a very high price.

oracknows Wed, 11/09/2016 - 02:00

The deadly false hope of German cancer clinics

oracknows — Tue, 08 Nov 2016 07:00:00 +0000

The deadly false hope of German cancer clinics

A couple of months ago, I discussed patient deaths at an alternative medicine clinic in Europe, where a naturopath named Klaus Ross had been administering an experimental cancer drug (3-bromopyruvate, or 3-BP) to patients outside the auspices of a clinical trial. 3-BP is a drug that targets the Warburg effect, a characteristic of cancer cells first reported in the 1920s by Otto Warburg in which the cancer cell changes its metabolism to shut off oxidative phosphorylation (the part of glucose metabolism requiring oxygen that produces the most energy) to rely almost exclusively on glycolysis and anaerobic metabolism. From a cancer cell evolution standpoint, one can understand why cancer cells would behave this way, as this change allows them to survive in environments with much less oxygen than normal cells, but the side effect of the Warburg effect is that cancer cells consume a lot of glucose for their energy needs. Indeed, positron emission tomography (PET scanning) takes advantage of this characteristic of cancer cells to use glucose labeled with a positron-emitting isotope that accumulates in cells. The result is that cancer cells, which in general use a lot more glucose than normal cells, light up compared to the surrounding tissue, allowing the identification of areas suspicious for cancer. Targeting the Warburg effect is therefore a strategy to attack cancer cells preferentially.

Since I wrote about the tragic deaths of those cancer patients, I’ve been seeing stories about German alternative medicine cancer clinics popping up in my newsfeed over and over again. Intuitively, you’d think that a scientifically advanced economic powerhouse like Germany would have stricter regulations over the practice of medicine, but, the more I looked into these clinics, the more I realized that there are a lot of quack clinics in Germany every bit as quacky as any clinic in Tijuana, but with a twist. Like Mexican alternative medicine clinics, German clinics often charge enormous sums of money for treatments that range from the unproven to the dubious to pure quackery. However, in addition to the rank quackery, German cancer clinics include legitimate experimental drugs that are as yet unproven and might even only have cell culture or animal evidence supporting its potential efficacy. Indeed, 3-BP is just such an example. It is a legitimate candidate cancer drug that’s in the pipeline, having shown promise in cell culture and animal experiments, but that has no human data from systematic clinical trials yet, just a handful of anecdotes when it was tried in humans under desperate circumstances. Not surprisingly, Klaus Ross’ main clinic is in Germany, and, like so many other clinics there, he was administering an as-yet-unapproved drug to humans.

So, prodded by a couple of recent stories from the UK, I decided to take another look at these German cancer clinics.

"Written off" by doctors and now doing well

In the world of alternative medicine cancer cures, testimonials for a treatment almost always include the patient bitterly recounting that conventional oncologists "wrote her off" before she discovered whatever miracle cure that she believes to have saved her. There are many variants. There’s the "I was given six months to live" (or one year or two months or whatever) trope, followed by the exulting that it’s now several years later and "I’m still alive." There’s the "doctors told me to put my affairs in order" trope. It turns out, though, that the vast majority of the time, the patient’s good fortune to remain alive can be explained by the biological variability of the disease, a mistake on the doctors’ part in estimating prognosis (always a tricky and inexact art), or a better response than expected to previous treatment with conventional medicine. Sometimes, these anecdotes rely on exaggeration on the part of the alternative medicine practitioner about the odds of surviving. I’ve deconstructed more of these testimonials over the years than I can remember.

Stanislaw Burzynski, the Polish expat physician (but not oncologist) who treats patients with what he calls "antineoplastons," is a master of this technique and several others to make it look as though he is saving lives when in fact he is not. For example, he routinely brags that there has never been anyone who has survived, for example, diffuse intrinsic pontine glioma (DIPG), and thus if there is any patient of his who survived it must be because of his antineoplastons. While it is true that the vast majority of patients with DIPG do very poorly, it is not true that none survive. There is even a registry of survivors maintained. It’s small, because few survive, but some do survive. Burzynski is also a master of exploiting diagnostic uncertainty. Because DIPGs, by definition, are located in the brainstem, often they are not biopsied because of the hazard and instead are diagnosed based on how they appear on MRI. It turns out that there are MRI abnormalities that can mimic the appearance of DIPG but are something else. Then there is biological variability. For example, deadly gliomas are indeed almost uniformly fatal within 12-18 months, but there is a "tail" to the survival curve, and patients surviving five years and beyond, while definitely not common, are not as uncommon as Burzynski would have you believe.

I mention biological variability because another aspect of these stories that can mislead the public is that patients frequently don’t understand that not enough time has passed to say with any confidence that they are survivors. This brings us to the story of Pauline Gahan, a rather extreme and sad version of this aspect of alternative cancer cure testimonials.

Because I have Google Alerts set up for various terms related to alternative medicine and cancer, I frequently become aware of stories about alternative medicine cancer cures. Such was the case last week, when a Google Alert led me to this snippet from an interview that aired Thursday a BBC Radio 5 show, under the title 'Why I spent 300k on "unproven" cancer treatment' abroad'.

This is a shorter snippet from a longer interview by Emma Barnett on 5 live Daily from October 20 with Pauline Gahan, a woman who spent £300,000 at a German alternative medicine clinic to treat her metastatic stomach cancer. To raise the money, she sold her house and her car, renting her house back so that she could continue to live there. The full segment begins around the 10:25 in the three hour radio show. Unfortunately, the story is framed around the question, "What do you do when the NHS says no? What extent will you go to?" Barnett does then note that an oncologist, Professor Karol Sikora, has expressed concern about patients from the UK are spending "vast amounts of money" on experimental treatments abroad with no proof of benefit.

A celebrity testimonial

We’ll get back to the full interview in a moment, but first I have to mention another pernicious phenomenon exhibited by this interview, and that’s the celebrity testimonial for alternative cancer cures. The first one I remember covering, at least with respect to German cancer clinics, is that of Farrah Fawcett, who in 2007 sought out a German cancer clinic for "experimental" treatment of her recurrent anal cancer. Although her publicist denied vehemently that she was being treated with alternative medicine, I couldn’t help but note that she was treated at Klinik Winnerhof in Bad Wiessee, which at the time was best known for galvanotherapy, also sometimes called bio-electric therapy. Not surprisingly, it is unproven and implausible. We don’t know whether Fawcett used galvanotherapy, but we do know that she did go to a clinic best known for offering it and that ultimately she died of her disease in 2009 at the age of 62.

Before interviewing Pauline Gahan, Barnett referenced the story of British actress Leah Bracknell, best known for having played Zoe Tate in the British soap opera Emmerdale from 1989 to 2005, who was diagnosed with stage IV lung cancer recently. What brought Bracknell into the news, aside from her being a celebrity with a terminal cancer diagnosis at a relatively young age (52), is that she has been raising money to go to a German cancer clinic. The last report I saw showed her having raised £30,000 of the £50,000 needed. Indeed, Prof. Edzard Ernst wrote about her story a couple of weeks ago noting:

Why Germany? You may well ask.

Germany has long been praised by fans of alternative medicine for its liberal stance on all sorts of unproven or disproven treatments. In Britain, there are just a few physicians who are devoted to alternative medicine; in Germany, there are thousands of them. In addition, Germany has a healthcare profession called the ‘Heilpraktiker’, a poorly regulated leftover from the Third Reich. Recently, a German Heilpraktiker was implicated in the deaths of several cancer patients who had travelled from abroad to receive his treatments, because German law is more liberal in these matters than other European countries. A Heilpraktiker has not studied medicine, yet is legally permitted to make all sorts of unsubstantiated claims and treat many serious diseases with unproven therapies.

Ernst notes that the German clinic to which Bracknell wants to go is the Hallwang Private Oncology Clinic. It turns out that this is very same clinic at which Pauline Gahan is being treated. So it’s worth taking a look at this clinic, what it offers – and what it claims.

Hallwang Private Oncology Clinic: Quackery, quackery, quackery

Upon learning the identity of the clinic where Bracknell wants to go and Gahan has gone, it befell me to fire up Safari and check out its website. Not surprisingly, the Hallwang Clinic website contains a number of very obvious red flags. For instance:

Healing-oriented and individualised medicine considers all aspects of lifestyle and not only relies on conventional treatments and recent cutting-edge developments in medicine, but also takes into account our experience in natural remedies and is open for alternative treatment options in order to work in synergy with conventional treatment strategies. We always try to be as natural as possible and as conventional as needed to achieve the best results. Integrative Health Concepts are successfully used in many diseases including malignant diseases, neurological disorders as well as in prevention and rehabilitation.

That’s nothing more than the usual blather you see on most integrative medicine websites, but take a look at what Hallwang offers: homeopathy, dichloroacetate (DCA), micronutrients and orthomolecular medicine, high dose vitamin C and other nutrients, whole body hyperthermia, ozone therapy and hyperbaric oxygen, and "many more according to your needs."

It should hardly need to be mentioned to my readers that homeopathy is pure quackery, but, given that its inventor Samuel Hahnemann was German, German quacks still seem to love it. I discussed DCA in the context of my discussion of 3-BP, because both drugs have a similar mechanism of action in that they both target the Warburg effect. DCA became popular among cancer quacks back in 2007 after a promising rodent study was published and made the news. Eventually, a pesticide salesman named Jim Tassano started importing DCA, which is easily synthesized, from China and other places, and selling it online. Thus was born DCA as an alternative cancer treatment. Like 3-BP, it is a legitimate experimental drug. It even has more evidence in humans that 3-BP. Unfortunately, like 3-BP, it is still thus far unproven, and its having been co-opted by quacks makes it doubtful that it will ever be validated as an effective cancer treatment. Then, of course, orthomolecular medicine and high dose vitamin C (and other vitamins) are pure quackery, as are ozone therapy and hyperbaric oxygen therapy (HBOT). HBOT has legitimate uses in burns and wound healing, but for cancer, not so much.

So what we have here is a clinic offering a variety of quackery, but there was another red flag, one that I can’t recall ever having seen on any alternative medicine clinic website before. Actually, more appropriately, it’s something I don’t recall ever having failed to see: who’s running the clinic and who the doctors are there. For instance, under Your Physicians, the website says:

We take pride in the commitment of our physicians to provide excellent care to our patients and their families.

Our team of head physicians and experienced clinical residents is specifically trained in internal and oncological medicine and lead an intensive research and academic program on cancer medicine.

That’s nice, but who are these physicians? I looked throughout the website and couldn’t find them. I did Google searches and couldn’t find out who runs Hallwang. Even the quackiest of quack clinics and naturopaths identify who runs the clinic and post short bios. The same sort of information-free blurbs can be found under Nursing Team. No, wait. There was one exception. The section on Psycho-Oncological Care shows a photo of someone named Benjamin Morlok, but not much else. Morlok has a Facebook page and a website, which identifies him as a financial coach, dream therapist, and cancer counselor. To say that I found this very odd and troubling is an understatement.

I was able to find a name, Dr. Jens Nolting, mentioned by patients on discussion boards here, here, and here, but I was able to find little or nothing else out about him.

Ultimately, I found more names, but that is a topic for tomorrow. In the meantime, let’s look at this narrative of false hope.

The false cancer narrative: Hope versus the NHS

With that background, let’s circle back to the story of Pauline Gahan. First, however, let’s take a look at the sort of news coverage she’s engendered in the UK media. Here’s a sampling of typical headlines:

There’s another pernicious narrative buried in these alternative cancer cure testimonials that is particularly prominent in stories out of the UK, and that’s to blame the NHS for not covering unproven treatments. Basically, many of the stories are spun in such a way as to portray the NHS as cold and heartless for not paying for unproven cancer treatments, which are portrayed as the patient’s only chance to live, whether they actually are or not:

Another example is here.

Notice how at the end of each story, it’s pointed out that the Gahans will have to raise a lot more money to continue the treatments.

It’s a narrative that popped up time and time again five years ago, when there seemed to be a steady procession of British patients with incurable brain tumors raising money in a very similar way to how Gahan and Bracknell are raising money to go to the Burzynski Clinic in Houston. Story after story portrayed these patients as victims of the NHS and the NHS as being too interested in saving money to pay for Burzynski’s "experimental" treatment. Being a government entity, the NHS was also an easy target for those with a political ax to grind. Never mind that the NHS trusts are quite reasonable in not wanting to waste government funds to pay for ineffective or unproven treatments in foreign countries. In fact, it would be quite irresponsible for the NHS to do otherwise. After all, should the NHS pay £300,000 for an unproven treatment? It just doesn’t make sense.

So what treatments did Pauline Gahan undergo, anyway?

So back to the story of Pauline Gahan, as told to Emma Barnett. Basically, she was admitted to the hospital in May with leg pain after a flight home from Australia, which turned out to be due to deep venous thromboses. She suffered internal bleeding from anticoagulation, which led to an endoscopy, which found stomach cancer. She had two "operations" for her clots. It’s not clear to me what those might have been, unless she underwent thrombectomy. She even admits that the reason she had trouble walking was because of her DVTs, which meant that she couldn’t fly to Germany and instead went there in a camper van. After three weeks there, she states that she felt much better. That could partially explain the pictures of her looking so ill back in May compared to how she looks now, which is much better. She was probably fresh from her diagnosis and the procedures done on her. Be that as it may, once again, a familiar story is told. A patient receives a devastating diagnosis. She hears testimonials from a dubious clinic. She decides to go there, but it’s expensive. So she and her family sell the house and car, undertake prodigious fundraising (e.g., through GoFundMe), and go to the clinic

Having been able to find so little in various news stories and on the Hallwang website, I was actually most interested in how Gahan described her initial treatment. According to her, every day she had five or six infusions, including vitamin B, and "liver detox." That didn’t interest me much, as it was fairly run-of-the-mill quackery that you can find at any naturopathic clinic. My main concern with the quackery is that none of it is effective for anything other than draining a patient’s wallet and that we have little idea how these treatments might interfere with the use of real medicines. Gahan also mentioned something that sounded like "renavap," but I couldn’t quite catch it. There is something called RenaVast, which is an unapproved veterinary drug claimed to be able to treat renal disease. Somehow I doubt that’s what the clinic gave her, as she said they told her it would transiently raise her body temperature. I note that German alternative cancer clinics are very big on whole body hyperthermia, but this sounds like a half-assed attempt at it, because usually when it’s done it requires the use of whole body thermal chambers or hot water blankets. There’s also not a lot of evidence that whole body hyperthermia is an effective adjunct to treat metastatic cancer, although there are clinical trials ongoing. It is at best experimental.

Again, one of the key characteristics of German alternative medicine clinics, particularly when compared to Mexican alternative medicine clinics, is that they often combine unapproved and experimental drugs with all the quackery. (True, Mexican clinics often administer stem cell treatments.) That’s why the next part of the interview is where my ears pricked up. Gahan mentioned that her immunotherapy consisted of a drug called Keytruda (generic name: pembrolizumab). This is a member of a class of new biologics and drugs known as immune checkpoint inhibitors. It’s a drug that is FDA-approved for metastatic melanoma and metastatic non-small cell lung cancer, with clinical trials having accrued for metastatic head and neck cancer and urothelial cancer.

I recently discussed immune checkpoint inhibitors, such as drugs and antibodies targeting PD1, a key protein, in the context of Vice President Joe Biden’s Cancer Moonshot initiative. Basically, drugs like Keytruda target Programmed T cell death 1 (PD-1), a membrane protein found on the surface of a class of immune cells (T cells), which, when bound to a protein known as programmed T cell death ligand 1 (PD-L1) on tumor cells, results in suppression of T cell activity and reduction of T cell-mediated immune responses. That’s why PD-1 and PD-L1 are referred to as immune down-regulators or immune checkpoint "off switches." Targeting this off-switch, shutting it down, can reactivate the body’s immune response against the tumor. There’s no doubt that immune checkpoint inhibitors are a big deal, and this class of drugs is one of the hottest areas of research in academia and pharma today. In some cases, dramatic responses have been observed using these drugs.

On the other hand, immune checkpoint inhibitors are no panacea. Even the Cancer Moonshot report acknowledges this:

The success rates of first-generation cancer immunotherapies, such as checkpoint inhibitors, genetically engineered T cells, and new immune activators have improved remarkably over the last 10 years, resulting in durable, long-term survival—and, in some cases cures—for a subset of patients with advanced cancers such as melanoma, blood, and lung cancers. However, only 10-20% of patients with these cancers have long-term responses to current immunotherapies. We must learn why some patients who have melanoma (such as President Carter) or lung cancer respond to checkpoint blockade immunotherapy, whereas patients with many other types of adult cancers, including ovarian, breast, pancreatic, brain, and prostate cancer—as well as most pediatric cancers—have brief responses or do not respond at all.

Gahan has stomach cancer, and there is actually evidence that Keytruda is active against stomach cancer—if the cancer makes PD-L1. The Lancet recently published a phase I trial of Keytruda in gastric cancer that studied 39 patients, 36 of whom were evaluable for tumor response. Eight patients (22%) were deemed to have had an overall response, but all responses were partial. Given that gastric cancer generally doesn’t respond well to chemotherapy, these results were actually pretty good, good enough to be considered sufficiently promising to warrant phase II clinical trials. It is, however, no miracle cure, contrary to the way it’s being represented to the press, which is how Hallwang appears to have represented it to Gahan. Actually, it’s not being represented at all, because most of the news stories don’t bother to identify the immunotherapy being used at Hallwang. They just call it "immunotherapy." It wasn’t until I actually listened to this interview that I could figure out which specific experimental treatment that Hallwang was actually using.

Hallwang also used some sort of vaccine therapy, which Gahan describes as having been made from her own DNA. It’s hard to tell what, exactly, Hallwang was doing, but it sounds like a neo-antigen vaccine. The basic idea behind such a vaccine is simple, although the production is very difficult. Tumor is collected by biopsy. Its DNA is sequenced and compared to the DNA sequence of normal cells. Mutations in the cancer cells are identified, of which there can be as few as ten or as many as thousands. Bioinformatics algorithms are then used to identify which mutated genes make cell surface proteins that could potentially serve as antigens, and peptides are synthesized in the laboratory based on the identity of those proteins to make a vaccine. The problem, of course, is that this technique is highly experimental as well, as this review article and article in the lay press show. It’s also, at least for now, very expensive because of all the sequencing, analysis, and synthesis of custom peptides that are required. Basically, it’s not clear whether these vaccines will pan out.

Did Hallwang cure Pauline Gahan?

Reading this story, you might well ask the question: Did Hallwang cure Pauline Gahan? It’s a reasonable question given her glowing testimonial and apparent good health now. The answer, sadly, is: Almost certainly not. I can hope that she is cured, and I can be happy that she is doing well, but my scientific knowledge of the natural history of metastatic gastric cancer tells me that she is incredibly unlikely to have been cured.

Unfortunately, the way this story has been presented is that Gahan is "almost cured." However, remember that she was only diagnosed less than six months ago. That’s nowhere near enough time to tell if she’s even survived longer than expected. For one thing, the five year survival rate for stage IV gastric cancer is 4%. So people treated normally with conventional therapy can and do survive five years. It’s very uncommon, but it happens. In fact, Gahan has just passed her expected median survival for a woman age 55-64, roughly five months. While I can understand the Gahans’ joy that their mother is still alive, from an oncology standpoint it’s hard to be too optimistic about how she’s doing less than six months after diagnosis. Not nearly enough time has passed.

Since none of us have seen the scans, we can only rely on her report that the tumors in her stomach, esophagus, and lymph nodes have disappeared and that she only has tumors left in her liver. What that means is that, after £300,000 of experimental drugs mixed with pure quackery, Gahan has had a respectable partial clinical response. In other words, she’s one of the lucky 20% or so whom we would expect to have had a partial response to Keytruda based on the study I cited above. Unfortunately, partial responses are not cures, and there’s little reason to expect that further treatment will eliminate the remaining tumors. It might, but even if that happens the most likely outcome will still be recurrence and death. We know this because we know gastric cancer is a nasty actor and that, once it’s metastasized, long term survival is very rare. Also, while there is no doubt that tumor shrinkage in response to therapy is certainly better than no shrinkage or tumor growth, tumor shrinkage often does not correlate with prolonged survival.

Perhaps the worst part of writing about these stories is having to be the voice of reality. That’s often misinterpreted as being the voice of doom, and I’m acutely aware that, should the Gahans read this, they will think I’m trying to crush their hope. In actuality, I really do hope their mother is cured and can live a long time, but that hope does not change my assessment of the Hallwang Private Oncology Clinic, which is selling false hope to desperate cancer patients like Gahan at a very high price. It doesn’t change my opinion that the Hallwang Private Oncology Clinic is engaging in very unethical behavior.

Hallwang: Combining quackery with misuse of cutting edge treatments

In thinking about the Hallwang Private Oncology Clinic and the many German cancer clinics that operate in a similar manner, I have to conclude that they are as bad as Stanislaw Burzynski, if not worse. Hallwang, for instance, doesn’t publish its results and won’t even report its results. Its < span=""> href="https://www.facebook.com/Hallwang-Private-Oncology-Clinic-414100488682843/" rel="nofollow">Facebook page might be full of testimonials of happy patients whose lives Hallwang claims to have saved and glowing scientific reports about immunotherapy of cancer, but none of these scientific reports actually come from Hallwang.

Basically, like any good con, Hallwang asks patients to trust its doctors, to take it on faith that its protocols do what is claimed for them. It does this in order to extract large quantities of money from their wallets, even if it forces them to do things like Gahan, such as selling their houses and other valuables, taking to the Internet to raise money, and going into deep debt to pay for a combination of seemingly state-of-the-art experimental therapies that haven’t been approved or validated for what they’re being used for plus outrageous quackery. After all, believing that Hallwang is the only place that can save your life is powerful motivation to go out and raise that money. As Prof. Sikora put it later in the interview, Hallwang uses very experimental treatments in a "blunderbuss" fashion, basically throwing everything but the kitchen sink together with no sophistication. We can’t even know if these doctors know what the hell they are doing. Patients are treated, and, as far as we can tell, no systematic record of how well these patients do and how long they survive is kept, or, if such records are kept, they are kept secret.

That’s the worst thing of all. Think of it this way. What if the doctors at Hallwang and other German cancer clinics really do have protocols using experimental drugs that cure cancers that can’t now be cured and save lives that can’t now be saved by conventional medicine? Failure to publish these protocols and their results is not just unethical, it’s downright criminal because, without publication, no other patients can benefit from their protocols unless they come to Hallwang. The doctors at Hallwang basically treat their protocols as trade secrets, so that their clinic is the only place such good results can be obtained.

That’s the best case scenario. Now let’s look at the worst case scenario.

Consider another possibility about clinics like Hallwang. Their protocols don’t work any better than conventional medicine. They almost certainly don’t even work as well as conventional medicine. However, combining a "make it up as you go along" approach to the use of experimental drugs with the addition of "holistic quackery" appeals to desperate patients who want hope, are prone to believe the "best of both worlds" sales pitches, and like the idea of "individualized" treatment regardless of whether it really is or not. Publishing their true results would be a threat to their ability to charge outrageous sums of money to patients like Pauline Gahan.

Of the two possibilities, the first is criminal, and the second is even more criminal. I also know which possibility that I consider more likely.

oracknows Tue, 11/08/2016 - 02:00

Categories

Brain and Behavior

Orac writes,

Because I have Google Alerts set up for various terms related to alternative medicine and cancer, I frequently become aware of stories about alternative medicine cancer cures.

MJD says,

I've been asked to submit a research article for publication.

However, the research article is related to alternative medicine and cancer.

A brief summary of the research article follows. (Note that certain words have been removed in the summary to avoid being permanently placed into RI automatic moderation :-)

The naturallergy-oncology perspective described herein explores how forced immunity to allergens from _____ may inhibit tumor growth and metastasizing. The over expression of mast cells and proteins from the Rho family of GTPases has been shown to manifest in multiple types of cancer. ______ is an allergen from _______ that has structure homology with members of the Rho family of GTPases. Forced immunity to _____ may provide IgE-primed mast cells that cross-react with members of the Rho family of GTPases, based on structure homology, and affect angiogenesis in tumors. Research efforts should be directed at exploring if forced immunity to ______ allergens can be used as a supplementary-treatment to inhibit tumor growth and metastasizing.

@Orac,

Once published, will you use the same RI zeal that was used in a a previous posting?

http://scienceblogs.com/insolence/2011/05/10/anti-vaccine-contortions-t…

Or,

Can a forward thinking alternative-medicine approach possibly become a viable therapeutic-intervention to inhibit the progression of cancer?

Please advise and minion comments are welcome...

Being a government entity, the NHS was also an easy target for those with a political ax to grind. Never mind that the NHS trusts are quite reasonable in not wanting to waste government funds to pay for ineffective or unproven treatments in foreign countries.

Which is how private insurers, who play a supplemental role in the UK and a similar role to the NHS in the US, would be expected to deal with the issue. The difference is that with the NHS it's a faceless government bureaucrat, not a faceless corporate bureaucrat, who is saying no.

My understanding from the west side of the pond is that the NHS has its problems, but it generally does a good job of providing basic care. I'm sure Orac's UK readers will have their opinions, which would be relevant here.

As someone living in the UK (and formerly the Netherlands) I'd say that government-provided healthcare like the NHS is usually pretty good, and if anything is too likely to allow treatments that are too costly for their effect. Definitely orders of magnitude better than the US's system where there's a good chance you need to sell one kidney on the black market to pay for fixing the other one with surgery. If anything, we here in west Europe need the governments to get their metaphorical heads out of their asses and actually look at reducing costs by not spending tons on stuff that doesn't work or doesn't work well. Sad to hear about Germany. They're usually considered the saner bunch of the continent... weird how different countries have such different flavors of nonsense somehow.

As for MJD's latest... musings... is it just me or does that sound like it's all theory, assumptions and what-ifs without any actual facts? Based on that summary I doubt we're going to see experimental results showing exposure to I-can't-believe-it's-not-latex-no-really resulted in altered angiogenesis in, say, mouse models.
Proof first, panic second.

Can a forward thinking alternative-medicine approach possibly become a viable therapeutic-intervention to inhibit the progression of cancer?

In the words of the great philosopher Minchin -

By definition, I begin
Alternative Medicine, I continue,
Has either not been proved to work,
Or been proved not to work.
Do you know what they call alternative medicine
That's been proved to work?
Medicine.

Bring proof and you won't have to call it "alternative".

It's relling that MJD supposed has been asked to write a "research" article - not to report on the results of completing any actual research. The effects of the gamma rays on the man-in-moon marigolds is sure to be rivetting.

It’s relling that MJD supposed has been asked to write a “research” article – not to report on the results of completing any actual research.

The usual name for such a thing in the scientific world is "review article". Such articles can be useful, as their goal is to summarize the current state of research on the topic of the paper, and normally contain a reasonably complete list of recent references on the topic. But in MJD's case, I think it's more likely to be GIGO.

unfortunate mjd sidetracks another good topic to garner attention for himself..again

I found the paper about phase 1b clinical trial of Merck's checkpoint inhibitor interesting, since I am used to phase 1's being mostly about dose finding. But there's no dose finding going on there, just peeking at efficacy. Perhaps it's like the trend of having multiple "expansion cohorts" in phase 1's that I sometimes think should be conducted and powered as phase 2's. I'm writing to see if there's someone who can teach me (us) more about this. Yes, I'm selfish.

Why is it that quacks, who are so fearful of "chemicals", always seem to recommend treating patients with things I'd handle with great caution, very, very carefully, if at all, in a lab?

Hyperbaric oxygen: everyone knows that high concentrations or pressures of oxygen can have serious, even fatal, effects. Oxygen is a neurotoxin at high enough partial pressure, and watch out for spontaneous combustion, a not inconsiderable possible side effect.

Ozone: deadly, very toxic, high explosive. Not even safe to store in a tank, it must be generated and used on the spot. Corrosive to cells, it is the white component of smog, and kills lung tissue if you inhale enough on high smog-index days.

Hydrogen peroxide, injected directly into the body: it is a strong oxidizing agent, kills and damages cells, and in high enough concentration it is a high explosive (in fact, rocket fuel).

EDTA and other chelation agents: fatal at high concentrations.

Halogenated carbon compounds like 3-bromopyruvate and dichloroacetate undoubtedly may be found to have some therapeutic uses, but carbon-chloride bonds are known carcinogens, and halogenated carbons in general are suspected ones. You must wear protective gear when using them, and I certainly wouldn't knowingly expose myself to large doses without them having been shown to have some proven therapeutic effect.

All of these, I would take great care with! But no, the quacks just inject or expose all of these to their patients!

OTOH, quacks will tell you how fearfully dangerous aluminum is, which, due to its strong bonding of oxygen to form an inert solid, is probably not very biologically active in aqueous media, like blood or a cell. And we don't fret much about handling it in a lab.

You best know what you're doing when exposing your "patients" to chemicals. Just any old thing that sounds good is probably something that actual chemists would shy away from.

Why be so hard on bromopyruvate? It sure beats gemcitabine.

A team of scientists at Yale published a series of experiments on bromopyruvate in 2014. They used a novel technique of encapsulating bromopyruvate in cyclodextrin. This is a neat trick to keep to bromopyruvate from reacting before it reaches the cancer cells.

They induced cancer in 42 rats and injected them with with either bromopyruvate, cyclodextrin-encapsulated bromopyruvate, gemcitabine, or cyclodextrin (control). The results were astounding.

The tumor progression was visualized by luciferin bioluminescence, and the images were superimposed over grayscale photographs in Figures 4 and 5. You can plainly see that the encapsulated bromopyruvate completely halted the progression of the tumors while gemcitabine wasn't much better than the control injection (cyclodextrin).

There are eosin-stained histological sections for those interested, and they also proved efficacy in vitro.

Here is a quote:

Daily intraperitoneal injections of b-CD–3-BrPA (5mg/kg in 500 mL saline) [cyclodextrin-encapsulated bromopyruvate] demonstrated strong anticancer effects with early effects visible on day 14 after the first injection (Fig. 4B). After 4 weeks of treatment, a comparison of BLI [bioluminescent imaging] signal intensity between the groups was performed. Animals treated with the b-CD [cyclodextrin only] control demonstrated a 140-fold signal increase over baseline. A moderate deceleration of tumor growth was observed in gemcitabine-treated animals with a 60-fold signal increase over time. Most importantly, animals treated with b-CD–3-BrPA [encapsulated bromopyruvate] showed minimal or no progression of the signal.

This is only one out of several experiments showing the efficacy of bromopyruvate on cancer via the Warburg Effect.

Systemic Delivery of Microencapsulated 3-Bromopyruvate for the Therapy of Pancreatic Cancer

In summary, the microencapsulation of 3-BrPA is a promising step towards finally achieving the goal of systemically deliverable antiglycolytic tumor therapy. The strong anticancer effects of b-CD–3-BrPA and the favorable toxicity profile pave the way toward clinical trials in patients with pancreatic cancer and potentially other malignancies.

@Garnetstar

Hydrogen peroxide, injected directly into the body: it is a strong oxidizing agent, kills and damages cells...

Hydrogen Peroxide is made by macrophages to destroy invaders. We are all producing hydrogen peroxide in our bodies right now.

... and in high enough concentration it is a high explosive (in fact, rocket fuel).

But not as explosive as nitroglycerin; an high-explosive used by mainstream cardiologists.

But nothing can outdo Lentonitrat. This cardiac drug is mostly pentaerythritol tetranitrate, one of the most powerful explosives known to man.

PETN (Lentonitrat) has a detonation velocity of 8,400 m⁄s. This is faster than TNT's and just short of RDX's.

The mainstream medical doctors prescribe much higher explosives than "the quacks".

@Garnestar

EDTA and other chelation agents: fatal at high concentrations.

Really? Calcium EDTA has an LD₅₀ of 2g/kg in rats.

I challenge you to find one patented pharmaceutical drug that has a lower LD₅₀.

http://www.sciencelab.com/msds.php?msdsId=9923899

MJD says,
I’ve been asked to submit a research article for publication.

Check the source of the invitation against Jeffrey Beall's list of predatory journals.

Another powerful study on bromopyruvate was done at Johns Hopkins and published in 2012. In this experiment, the researches used luciferin bioluminescence for in vivo analysis of experimentally-induced rat lymphoma.

The results are striking. The bioluminescent images are presented in Table 4 and show a marked reduction of tumor growth over the control group. Fig 3a shows the effect of daily injections of bromopyruvate, and Fig 3b shows the slight reduction of a one-time dose on day one of treatment.

The results indicate that daily injections of bromopyruvate significantly inhibits tumor growth over controls. Here is a quote:

To our knowledge, this is the first report to analyze the activity of 3-BrPA in a systemic lymphoma model. Overall, 3-BrPA showed marked reduction in tumor activity in vitro. Repeated systemic i.p. administration of
10-mg/kg 3-BrPA showed a significant reduction in tumor
activity with only minor toxicity in mice compared with a randomized control group. Based on these data, 3-BrPA holds promise as a therapeutic agent for treatment of aggressive systemic metastatic cancers.

Systemic administration of 3-bromopyruvate in treating disseminated aggressive lymphoma
NIKLAUS G. SCHAEFER
JEAN F. GESCHWIND
JAMES ENGLES
JULIA W. BUCHANAN
RICHARD L. WAHL

The most comprehensive and powerful study done on bromopyruvate was published in 2008 by The Journal of Pharmacology and Experimental Therapeutics. This study used rabbits and four dosage groups.

The experimenters used ¹⁴C-labeled bromopyruvate in addition of ¹⁸F-labeled fludeoxyglucose to measure tumor glycolysis. One group of rabbits were given ¹⁴bromopyruvate via the left hepatic artery, two groups were given different doses intravenously, and one group was given saline.

This also included a small survival study. There are no PET images to see, but Figure 2 graphs the tumor uptake of ¹⁴bromopyruvate and Figure 3 illustrates how bromopyruvate blocks the glycolysis of ¹⁸fludeoxyglucose in the tumor.

Figure 4 shows the 269% increase in survival for bromopyruvate-treated rabbits, and Figure 6 is an eosin-stained slide illustrating the non-toxicity of bromopyruvate on non-cancerous liver tissue.

I will let the others summarize the rest, since they do a fine job at this:

The uniquely selective targeting properties of 3-BrPA are evident compared with those of other conventional chemotherapeutic agents. One report using ¹⁴C-labeled doxorubicin in a mixture with lipiodol in the same VX2 rabbit model showed that almost all of the doxorubicin disappeared from the tumor immediately after infusion. Therefore, targeting of the tumor by doxorubicin could not be achieved.

The selective uptake is evident by the data. The tumors incorporate more bromopyruvate than health tissue. Radio-labeled bromopyruvate allowed them to test this effect. Bromopyruvate beats doxyrubicin in this regard as well as in it's toxicity profile.

The second aim of our study was to evaluate the survival benefit of i.a. administered 3-BrPA in rabbits implanted with the VX2 liver tumor. Our experiments were conducted using the already established dose of 1.75 mM in 25 ml of PBS infused i.a. over 1 h. Treated rabbits had a significant increase in survival compared with the control group. This extension of life span by 36 days or 296% provides convincing evidence for 3-BrPA-mediated survival benefit.

This is significant. I'll have what they're having.

Noteworthy is the absence of toxicity to the normal liver on histopathological analysis, which is in keeping with previous data from our laboratory...

They also decided to retain a very small group of three rabbits indefinitely. They achieved one cure:

To address this issue, a subgroup of three animals was treated earlier in their disease, i.e., 1 week after tumor implantation mimicking earlier stage liver cancer in humans. One of three animals showed no evidence of recurrence and was considered cured 10 months after treatment. When the liver was excised at the time of sacrifice, a small (less than 1 cm) calcified lesion was present at the site of the tumor, confirming complete tumor destruction.

Targeting of VX2 Rabbit Liver Tumor by Selective Delivery of 3-Bromopyruvate: A Biodistribution and Survival Study
Mustafa Vali, Josephina A. Vossen, Manon Buijset al

Katie, you may think you're adding something meaningful to this discussion, but you are not. Orac even acknowledged that bromopyruvate is a promising drug.

The complaint was never that bromopyruvate is a quack alternative drug that never works - the complaint is that patients are being charged exorbitant prices for bromopyruvate for the treatment of cancers it has never been tested in.

We're all fans of research, and we all hope bromopyruvate is proven to help more and more types of patients. But Orac, myself, and many regulars to this blog hate and detest "doctors" who make false promises to patients and then bankrupt them chasing experimental treatments.

Your points about medical explosives are true, but also irrelevant. The key is the cost/benefit analysis. Yes, nitroglycerin is explosive, but not at the concentrations used in medicine, and has actual medical benefits.

Ozone has no medical benefits to speak of (aside from use as a disinfectant in the distant past), so any amount of risk is unacceptable.

@Bob

Your points about medical explosives are true, but also irrelevant.

No shiτ. Couldn't you see that I was merely refuting Garnestar's mention that hydrogen peroxide is explosive. His implication seemed to be that explosive compounds have no place in medicine.

... and has actual medical benefits.

Are you implying that hydrogen peroxide has no medical benefits?

Katie, you may think you’re adding something meaningful to this discussion, but you are not.

And what have you added you twerp? You have not added anything remotely meaningful. I presented the three most promising studies on bromopyruvate, and they all showcase it's powerful ability to inhibit cancer. Bromopyruvate is safer and more effective that gemcitabine.

If that isn't relevant to a discussion on bromopyruvate then I don't know what is.

All of the rest of you merely lob insults at anything remotely "alternative", as if the FDA should have the final say in what constitutes a therapeutic treatment.

I have a hard time believing that patients are charged hundreds of thousands of dollars for bromopyruvate. You can buy it for about $10/g from Sigma-Aldrich. You are going to need a citation for these outrageous claims.

http://www.sigmaaldrich.com/catalog/product/aldrich/16490?lang=en&regio…

Could they selectively and completely destroy cancerous tumors in animals? This led to the discovery in an experiment conceived, designed, and conducted by Young Ko that the small molecule 3-bromopyruvate (3BP), the subject of this mini-review series, is an incredibly powerful and swift acting anticancer agent. Significantly, in subsequent experiments with rodents (19 animals with advanced cancer) Ko led a project in which 3BP was shown in a short treatment period to eradicate all (100%).

3-Bromopyruvate (3BP) a fast acting, promising, powerful, specific, and effective "small molecule" anti-cancer agent taken from labside to bedside: introduction to a special issue.

The people I know that have gone this route either exhausted their conventional options or their own patience after 1+ years and iatrogenic injury within the English speaking, conventional medical systems.

All the people were within the top 1-5% intelligence wise, and had their own earned funding. I would estimate their expenditures comparable to the US - probably less than CTCA and maybe perhaps about MSKCC or less, allowing for taxes. Although I've learned 1-2 tricks watching e.g. a biomarker and a little about it's logic, mostly I reassure myself that I haven't missed consideration of some important unknown option(s).

From my perspective, perhaps these clinics are too "oncological" in going to MTD with some treatments that they do. They are not careful and consistent enough in application for my taste. They are well outside my budget. A techie might even do better at home than any of the institutions including the US ones, outside of ER, surgery, scans or super specialty tx.

This is just another ill informed diatribe on vitamin C. With IV vitamin C, cancer patients often get 1-7 good days from their miserable existence - a sprayed and kicking cockroach is my mental image of some maimstream patients' situation without it. The one day being more representative of someone with 80-90% liver replacement by cancer.

Probably more intricate is to get oral and IV vitamin C to consistently function as an additive adjunct to some chemo formula. Perhaps not simple enough for some amateur with an MD, a bias, and an attitude.

Hi Katie,

I don't know how much alt-med patients pay for bromopyruvate, but I doubt they're straight up injecting what they buy from Sigma. We see figures of patients spending £30,000-300,000 on treatment protocols that include this drug, but the quacks don't give us an itemized bill, so in principle I don't know that they were stiffed on the bromopyruvate, something else, or everything.

And again with the animal studies - why do you keep bringing this up? The FDA puts a higher bar on drugs for a reason: people have fucking *died* from clinical trials, not to mention how many drugs with promising effects in animal models wound up being dangerous or ineffective in humans compared to existing standard of care (re: most of them).

Beyond concern for the medical and financial safety of patients, there is also the tangential issue of quacks advertising that any drug or treatment will cure a patient's cancer when the evidence is either non-existent, confined to animals, or only pertains to a different disease.

It sounds like you have a bone to pick with the FDA, or perhaps the scientific-medical community in general, since the subject of the this article was treated in the UK and Germany.

So how would you like things to be? Should doctors be allowed to prescribe any drug based on pre-clinical studies? Should insurers be forced to pay for it? You might want to look up John Ioannidis.

Or is this just a "health freedom" thing? In that case, I'd ask a similar set of questions: Should doctors be allowed to advertise drugs as working based solely on pre-clinical studies? Should insurers be forced to pay for a patient exercising his freedom to take unproven drugs?

The people I know that have gone this route either exhausted their conventional options or their patience after 1+ years and iatrogenic injury within the English speaking, conventional medical systems.

All the people were within the top 1-5% intelligence wise, and had their own earned funding. I would estimate their expenditures comparable to the US – probably less than CTCA and maybe perhaps about MSKCC or less, allowing for taxes.

Although I’ve learned 1-2 tricks watching e.g. a biomarker and a little about it’s logic, mostly I reassure myself that I haven’t missed consideration of some important unknown option(s).

From my perspective, perhaps these clinics are too “oncological” in going to MTD with some treatments that they do. They are not careful and consistent enough in application for my taste. They are well outside my budget. A techie might even do better at home than any of the institutions including the US ones, outside of ER, surgery, scans or some super specialty treatment.
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This is just another ill informed diatribe on vitamin C. With IV vitamin C, cancer patients often get 1-7 good days from their miserable existence – a sprayed and kicking cockroach is my mental image of some maimstream patients’ situation without it. The one day being more representative of someone with 80-90% liver replacement by cancer.

Probably a little more intricate is to get oral and IV vitamin C to consistently function as an additive adjunct to some chemo formula. Perhaps not simple enough for some amateur with an MD, a bias, and an attitude.

The Young Ko article mentioned above is very interesting. He achieved a 100% success rate (n=19) with bromopyruvate in mice. He injected them with carcinoma cells. The article can downloaded here and is full of lovely color photographs:

Advanced cancers: eradication in all cases using bromopyruvate therapy to deplete ATP
Just click on the "Download .pdf" button!

A few quotes from the article:

Table 1 provides information about the 34 female rats in this study divided into Groups 1 and 2. Group 1 animals, named ‘‘One Dottie,’’ ‘‘Two Dottie, ‘‘Three Dottie’’ ‘‘Tiny 9’’ ‘‘Star,’’ and ‘‘Tip,’’ had their abdominal cavities filled with rapidly proliferating HCC cells...

He gave them cute names...and then he injected them with rapidly proliferating carcinoma.

But it has a happy ending...

HCC cells growing internally in the abdominal cavity of test animals, and all advanced tumors (HCCs) projecting externally, regressed, and disappeared after 3-BrPA therapy

Sounds cool. What about the ones on their backs?

All advanced solid tumors (HCCs) growing in the upper backs of test animals also regressed and disappeared following treatment with 3-BrPA

Figure 7a has cute pics of all the surviving mice!

Here's someone trying to collect $18000 for a course of treatment. But that sounds like the patient hopes for treatment from Vogl, using TACE, which is sufficiently invasive, hi-tech and skill-dependent to justify the price.

I have a hard time believing that patients are charged hundreds of thousands of dollars for bromopyruvate

Katie, you may be misreading Orac's statement that "Pauline Gahan spent £300,000" (by her own account). That was not just for 3BP; it was for Keytruda immunotherapy, bespoke synthesised vaccines, and heaven know what else.

(I thought I sent this message before, but it didn't make it through)

Hi Katie,

I don't know why you keep bringing up animal trials of bromopyruvate. And no, it's not relevant to discussion, because Orac acknowledges that bromopyruvate is a promising cancer treatment that deserves further study.

No, the controversy is over the fact quack doctors are already advertising and selling 3-BP, claiming it will cure patients' cancers, despite the absense of clinical trials proving its safety and effectiveness in humans. No number of animal studies is going to make that problem go away.

As for the price, all I know is that quacks are charging £30,000-300,000 for a course of treatment that includes 3-BP. I haven't seen anyone published an itemized receipt, so in principle I can't know how much of that amount is 3-BP and how much is aspects of the treatment.

So, what exactly is your problem with the FDA, especially considering this case involves the UK and German health authorities? Do you think doctors should be allowed to advertise and sell drugs based solely on animal studies, drugs that have not gone through the clinical trial process? Do you think public or private health insurers should be forced to pay for experimental treatments?

Or maybe this is a health freedom thing, everyone should get to have any treatment they want? Well, in that case, do you still think it's OK for a doctor to advertise a drug as effective when there are no human clinical trials to support that claim? If you think promising preclinical trials suffice, you may want to read some of John Ioannidis's work. Most drugs that show promise in preclinical and early-phase clinical research ultimately fail to prove safe and effective compared to standard of care. And that's why the FDA insists on the clinical trial system.

Really? Calcium EDTA has an LD₅₀ of 2g/kg in rats.

Hi, Fucklesworth.

@ Katie Schreiber

Hydrogen Peroxide is made by macrophages to destroy invaders. We are all producing hydrogen peroxide in our bodies right now.

Oh for Pete's sake.
Reactive oxygen species (ROS) are created all the time by phagocyte cells, true enough, but they are produced in a specialized organelle inside the cells, and carefully applied to the phagocyted invaders.
They are also occasionally released at the surface of infected cells, and in this case the targeted cells are expected to die. A strong inflammation and lots of tissue damage are the result of such a release (granted, there are other participating molecules being released at the same time).

They never reach locally the quantities you will reach by injecting the product straight from a syringe.

Katie Travis, you may be misreading Orac’s statement

FTFY while my previous comment is deliberately in moderation.

bulshit. just replace "ALTERNATIVE" to "conversional" word and you get same results - all conversional clinics are quackers. they dont cure! it takes 10 and more years to accept drug . think cancer patient must stay at home and die? do dead people needs money? they need hope and a chance. thats why they are going to another direction. athtor is fu... moron . i wish you have cancer and we'LL see what you will do...

dm, I think you're flying a little bit off the handle when the article is describing how people looking for hope and chance get taken advantage of, with treatments that cannot support an evidence-based benefit and are outside of a rational approach to fighting a disease to begin with. Not everything is a 10 year process to see a trial result that won't work, and creates harm. The article shows the opportunism, taking advantage of people in their worst moments of their life.

I get frustrated at the uncritical reporting of these alternative clinics, no reporter digs into whether the costs are reasonable or makes any attempt at meaningful comparisons to standard care. They are happy with the usual uncaring bureaucracy vs plucky patient story arc. This goes for $10K for antibiotics for ChronicLyme to $100K for cancer "cures". The assumption appears to be that magic is supposed to be expensive.

Katie,

But nothing can outdo Lentonitrat. This cardiac drug is mostly pentaerythritol tetranitrate, one of the most powerful explosives known to man.

It is fascinating how chemicals can have other uses, isn't it? The one that surprised me when I learned about it was medicinal hydrazine. Hydrazine sulfate is used as a chemotherapy agent. And other forms of hydrazine --particularly monomethyl hydrazine (MMH) and unsymmetrical dimethyl hydrazine (UDMH) -- are used as rocket propellant. It has three great advantages. One is that its density isn't too shabby*, another is that it is stable and storable over long periods of time (provided you don't let it freeze), and the last is that it is hypergolic with nitrogen tetroxide (N2O4). N2O4 is also conveniently storable, and the hypergolic nature of the mixture means they spontaneously ignite on contact, so it's a much simpler ignition system. Unfortunately, both hydrazine and N2O4 are quite toxic; the US has completely eliminated the use of them in first or second stage rockets, but alas, there is no suitable alternative for most spacecraft rocket applications. Voyager 1 still has a supply of MMH monopropellant**, loaded in the 1970s and still good today; the spacecraft occasionally uses a bit to maintain its proper orientation.

*this is the main problem with liquid hydrogen -- although chemically pretty much the ideal fuel, the density is atrociously low, necessitating enormous tanks

**as a monopropellant, it is allowed to flow past a catalyst that triggers it to decompose violently into ammonia, nitrogen, and hydrogen. H2O2 got mentioned earlier in this thread; that is one of the ways it has been used as a propellant as well -- it is induced to decompose by passing it over a catalyst. However, it is far less convenient than hydrazine.

Eric @2

As a retired NHS employee, it was long my opinion that the main problems with our ability to provide healthcare fall into the following groups:

constant political interference, resulting in restructuring after reorganisation after organisational change, which wastes limited resources on things which are never evaluated nor given time to see if they might work and have no relevance to clinical services anyway;

deliberate limiting of funds or cutting funds by Conservative governments (someone recently FOI'd some info about how my bit of the forest - MH - had been hacked to bits since May 2010);

poor commissioning of services (my bit of MH was commissioned for years by folk who had no idea about it and wrote ridiculous contracts);

the cult of managerialism, which means that unsuitable managers are given more power and say than any clinician in what is done and how.

Oh, and I should repeat what I've said before that the bulk of the UK media (owned by foreign-born or foreign, i.e. tax exile, resident billionaires) have long had an ideological objection to the NHS and these sorts of stories are a means of driving their narrative about the NHS failing.

Why is it that quacks, who are so fearful of “chemicals”, always seem to recommend treating patients with things I’d handle with great caution, very, very carefully, if at all, in a lab?

Hyperbaric oxygen: ...

Ozone: ...

Hydrogen peroxide, injected directly into the body: it is a strong oxidizing agent...

Don't forget that according to Crislip's Law, that for every scam, there is an equal and opposite scam. In this case, it's antioxidants. Eat enough of them, and all those problems and more will go away.

/sarcasm

Orac:

Its for sure

Removab (Catumaxomab), not that vet drug!
regards, Mic (from Germany)

in your article you mentioned the names of my doctors: Dr Ursula Jacob and Dr Kopic. They are not quacks in any way, Dr Kopic received my cousin with stage 4 brain tumor sent home from treatment in america with no hope, she was blinded in one eye from an inoperable growing tumor. she is cured now with all the methods you criticize. no surgery, her blood is cancer clear, tumor died and is gone; it shrunk to death. and her eye is not blind any more, also my Aunt is no longer diabetic and needs no medication. I am cancer free now. Go see the people walking healthier than ever expected that these doctors have treated, you will be shocked, ask for these doctors statistics, you will be shocked. soon this kind of cancer treatment will be worldwide and affordable to all. this article seems an attack without proper research of those who's lives were saved and extended way beyond expected. why would so many educated people go for these treatments if they don't work ? ask the sick who have been cured of so much not just cancer. the numbers will astound you. yes it is expensive (for now) (your article does not help) And articles like this will cause the death or suffering of people who could have been living illness free and cancer cured. if they believed it. This article kills hope of a very valid treatment method and names doctors that have saved so many no hope people. it is a disgrace, bad research online without statistics or examples of the cured. not a well researched article, one sided and ignorant due to the lack of information from those who have been saved by these doctors. it is sad and cruel. please look into it further from the view point of the people being treated. Be professional the thorough in the information you research. Get on a plane and go see, the doctors wont say no. ask for cases and talk to the people they have cured. Get your facts, not your opinion and flimsy research. thank you