Stanislaw Burzynski treats cancer patients at a private clinic using what he terms “antineoplastons”: mixtures of peptides, amino acids, and other simple organic substances that are said to promote the body’s natural defenses against cancer. He has published his own studies, but nobody has been able to reproduce the clinical results he claims to have achieved. Recently a movie was released that allegedly shows irrefutable proof that his therapy works as a cure for cancer and that the rest of the medical establishment is conspiring against him.
In this post we will not concern ourselves with conspiracy talk: all we are interested in is to review the evidence presented in the movie (click here).
Right at the opening it says:
“This is the story of a medical doctor and PhD biochemist who has discovered the genetic mechanism that can cure most human cancers. The opening 30 minutes of this film is designed to thoroughly establish this fact — so the viewer can fully appreciate the events that follow it.”
This is followed by an excerpt from a congress hearing; an interview with a practitioner of alternative medicine and a description of the idea of antineoplastons.
The next part of the movie consists of three testimonials, including documentation. It is those testimonials that are intended to prove beyond a reasonable doubt that antineoplastons are effective as cancer treatment. Well – if it works we really want to know about it, so let’s take a look at the “anecdotal evidence”.
The transcript is here and the “Diagnosis & recovery documents” can be found here.
The first patient whose case is presented as evidence is a female diagnosed with an anaplastic astrocytoma. We are told that a CT-scan revealed a mass in the brain measuring approximately 2 cm. In the movie we are shown a glimpse at the MRI-report and a pathology report telling us that the mass was an anaplastic astrocytoma. It is right here that the documentation shown in the movie becomes problematic. Here is the conclusion of the MRI-report:
The yellow marking is what the people behind the Burzynski movie want you to focus on. But the next sentence is very important too, because it tells us that the lesion could also be a lymphoma or an inflammatory process. This is important because primary treatment of neoplasms like astrocytoma is surgery. Lymphomas are treated with chemotherapy and inflammatory conditions are treated by other means depending on the nature of the inflammation. So in order to know whether such a patient should be treated primarily with surgery, chemotherapy or something else, a biopsy is needed. And a biopsy was taken in this case: it was a core biopsy, measuring 1 cm in length and a diameter of 1-2 mm. The following is not shown in the movie, but it is very important:
It tells us that the diagnosis was given by the pathologist during the operation. A frozen section analysis provides information to be used in deciding whether or not to proceed with surgery. Had the diagnosis been lymphoma, the decision would have been a no. This diagnosis establishes a reason to proceed with the surgical procedure. So we are right in asking ourselves if she did have further tumour tissue removed. At the start of the testimonial we were told that the astrocytoma was inoperable. Well – it was accessible for biopsy, so how then could it have been inaccessible to surgery? And this is what we are shown of Burzynski’s monitoring of the tumour size by MRI, starting before the antineoplaston treatment:
The lesion measured originally about 2 cm, but right before antineoplastons treatment, it appears to have been reduced in size to 0,5 cm. This is highly suggestive of something having happened after the biopsy, and surgery makes sense. An inflammatory reaction is a normal part of the healing process following surgery. It would accordingly be expected to find an inflammatory reaction at the site of surgery. Remember what it said about other possibilities than in the original scan:
So based on what we are told and what we can deduce from the documentation, there are two possibilities:
1) A 2 cm anaplastic astrocytoma was biopsied. Without further intervention it shrunk to 0,5 cm.
Antineoplastons made the rest go away; this is in fact what the movie claims.
2) A 2 cm anaplastic astrocytoma was biopsied and then surgically removed. The subsequent inflammation
resolved on its own.
Here is the transcript and here are the “Diagnosis & recovery documents”.
The second patient is a female who at age 11 was diagnosed with a brain stem lesion. We are told that the MRI showed a diffuse brain stem glioma. and then we are shown an MRI-scan which shows a relatively small tumor in the brain stem (shown yellow).
None of us on the blog are neuroradiologists, so we have to consult textbooks to figure out what a diffuse brain stem glioma looks like. There’ one here. It has a chapter on brain stem gliomas, and on page 260 section 18.104.22.168 it says the following about the diagnosis of diffuse gliomas:
“….are poorly defined and as a rule occupy more than 50% of the axial brainstem diameter”.
Judge for yourself if you think the yellow marked lesion well defined or poorly defined. But it is not even close to occupying 50% of the diameter, so it is not a typical diffuse brain stem glioma, judging by the MRI. Perhaps we can find the explanation in the MRI-report. We must assume that the MRI-scan was examined by a neuroradiologist, who knows when something that doesn’t look like the textbook description of a diffuse brain stem glioma still is a diffuse brain stem glioma. Here’s what it says in the MRI-report:
No mentioning of a diffuse brain stem glioma here. It is also questionable how reliable the MRI-diagnosis of a brain stem glioma really is. In this study the researchers looked into what was seen in biopsies from 46 lesions diagnosed as gliomas on MRI. Only in 28 of the cases were the glioma diagnosis correct. In 6 of the cases the lesions were benign (non-cancerous).
Another interesting observation can be made in the chart showing changes in the size of the lesion during Burzynski’s treatment:
Between the MRI-diagnosis and the first MRI-scan at Burzynski’s clinic, just before the start of the antineoplaston therapy, the size has diminished from approximately 2 cm to 1 cm. This suggests that either something has happened which we are not told about, or this is something that has decreased to half the size all by itself. This casts serious doubts on whether the subsequent antineoplaston therapy actually did anything in this case.
So, based on what we are told and what we can deduce from the documentation, there are three possibilities:
1) A diffuse brain stem glioma which did not look like a textbook example of a diffuse brain stem glioma on MRI and which was not biopsied, diminished to half its original size on its own and then Antineoplastons made the rest go away.
2) The lesion was a benign non-cancerous condition that resolved by itself.
3) The lesion was treated successfully by conventional treatment.
The transcript is here, the “Diagnosis & recovery documents” are here and here.
We are told that a 6 months old baby is diagnosed with a base ball sized tumor in her abdomen. “It is in her kidney and everywhere…. in her liver and her lungs…” The next thing that happens is surgery, where the abdominal mass is removed.
We are presented with parts of a pathology report where we can see that “The kidney is not involved” and the final microscpic diagnosis ends with “See comment”. This tells us two things:
1) The parents are wrong when they say that the tumor was in the kidney by the time of diagnosis.
2) The diagnosis wasn’t all that clear cut. “See comment” is something pathologists add to the final microscopic diagnosis, when the mere diagnosis can’t stand on its own. For instance, if not all criteria for making the diagnosis are present, there might be uncertainty as to how the tumour should be classified. Here is what it says in the comment:
Basically, this means that the case has been discussed, and weighing all things, they classified the tumour as an arenocortical carcinoma (a distinct type of adrenal cancer). We are unable to assess the reason for this uncertainty, because we are not shown the relevant part of the pathology report containing the microscopic description. This is typically where criteria present for making the diagnosis are mentioned, and any uncertainty in the interpretation is discussed.
The microscopy slides were also reviewed at another institution (MD Anderson Cancer Center). And again their diagnosis is “Adrenal neoplasm consistent with adrenal cortical carcinoma (See comment).” Here are those comments:
Basically this confirms that there is uncertainty of the cancer diagnosis, and they intend to use immunohistochemistry to help in deciding if this diagnosis is correct. We are not shown the content of the supplemental report, but we are shown an indication that such a report was indeed issued. The above report was signed out 9/26/2005 1:45 PM. Then there is this:
Something was signed out 9/29/2005 which has not been cleared or approved by the FDA. It can only be the immunohistochemistry, because the rest consisted merely of looking at microscopy slides from the original pathology lab.
So what’s the fuss all about? Well, there is one very important differential diagnosis that has to be taken into account: adrenal cortical adenoma, which is the benign non-cancerous counterpart of an adrenal cortical carcinoma. In the WHO publication on classification of tumors in the endocrine organs there are no less than three scoring systems and they mention that there are more such systems. A scoring system typically lists a set of characteristics, and the more of these characteristics are present in the tumour, the higher the score. If the score is high enough, the tumor is classified as a carcinoma (cancer), and if it is lower, the tumor is classified as an adenoma. The snippets of the pathology reports presented do not allow us to assess how this tumor scored in any of the classification systems. But the above certainly does indicate that it is in the grey area.
Then we are shown a preliminary radiology report where it says that there are progressing lung metastases:
A preliminary report is just what it sounds like: a first impression, which may be interpreted in a different way in the final report. We will never know what it says in the final report, because it is not shown to us.
So what happens after the parents decide to go for the antineoplaston therapy? Well – According to the movie:
“By this time, Kelseys cancer had also spread to the liver”.
This means the parents were incorrect when at the beginning of the testimonial they said the cancer was already in the liver by the time of diagnosis. The first CT-scan demonstrating a small liver lesion at Burzynskis dates 22-2-2006, which is almost 6 months after the operation.
The lesion in the liver is regular with “low attenuation”. It is not diagnostic of a liver metastasis (although it is a possibility). According to the movie, no attempts have been made to verify if this is a metastasis or something else.
So what do we have here:
1) The parents’s information on how widespread the tumour was known to be at the beginning, is demonstrably unreliable.
2) There is uncertainty as to whether the tumour really was cancer.
3) The tumour was successfully removed by surgery.
4) Liver and lung lesions of unknown nature decreased in size as time passed.
With the incomplete and insufficient information we have, it is impossible to accept this testimonial as evidence that antineoplastons cured this baby of metastatic adrenal cortical carcinoma. So what are we to think about the opening statement in the movie:
The opening 30 minutes of this film is designed to thoroughly establish this fact—so the viewer can fully appreciate the events that follow it.”
There is no evidence that the cancer of any of the patients presented in the movie was cured or even improved with antineoplaston therapy, and based on Burzynski’s “evidence” it seems only fair that some are trying to put him out of business.
Stanislaw Burzynski: bad medicine, a bad movie and bad PR
Dr. Burzynski and the cult of personality of the “brave maverick cancer doctor”
What dr. Stanislaw Burzynski doesn’t want you to know about antineoplastons
Hope or False Hope
The Other Burzynski Patient Group
EDIT TO ADD:
The testimonials in the movie are not the only ones that fall apart under scrutiny. See for instance this.