Here is the article that allegedly document this claim. But the article does no such thing. The article reports fundings to biomedical engineers who are working on a method to measure pH inside cancers.

Cancers are often more acidic than the rest of the body. How this comes about is described in this post. This may influence the efficacy of some types of chemotherapy. And it may also influence the cancers ability to spread.

There are two paragraphs in the article that may appear to support what the baking soda supporters claim. We will start taking a look at this one:

Drinking baking soda has been proven to reduce or eliminate the spread of breast cancer to the lungs, brain and bone, but too much baking soda can also damage normal organs.

These are the words of the journalist, not necessarily the words of the scientists involved and it may be rooted in the research done by one of the collaborators. The article mentions Ian Robey, assistant professor of research at The University of Arizona Cancer Center. His groups research has previously been misrepresented by followers of Tullio Simoncini.

But let us check a out for  ourselves if it has been proven that drinking baking soda reduces or eliminates the spread of breast cancer to the lungs, brain and bone.

Robey and his group looked into what happens when experimental mice implanted with a cancer cell line are fed with sodium bicarbonate. Since mice are not men, one should always be cautious about concluding directly from such experiments to effects in humans; without experiments in humans it has not been proven to work in humans. However, the results of such experiments can still be informative.

Here is one research paper by Robey’s group  that we will take a look at. The main results were:

1) pH was raised in the tumour stroma, but not inside the tumour cells.
2) pH was unchanged  in normal tissue  (ie. the rest of the body).
3) There was a reduction in number and size of metastases.
4) Nothing happened to the cancer itself.

So this study does not prove that spread is eliminated by drinking baking soda.

Here is another interesting paper by Robey’s group. In this study they looked into DCA and sodium bicarbonate (separately and combined). DCA didn’t have any effect, but we won’t go into further details of that aspect of the paper here. Concerning sodium bicarbonate, the main results were:

1) Nothing happened to the cancer itself
2) The amount of metastasis were lower in mice treated with sodium bicarbonate. But the difference was too small to rule out that this observation was a play of chance (i.e. not statistically significant).

So this study does not prove that spread is eliminated by drinking baking soda. It doesn’t event prove that metastases are reduced.

Here is another paragraph in the article:

……Jennifer Barton, professor and head of UA biomedical engineering. “Patients can actually change their body’s pH to make their cancer drugs more effective — it can be as simple as drinking baking soda — but this process has to be carefully monitored.”

The critical word in that paragraph is “body”. In various fora where the article is presented as endorsement of Simoncini’s idea, we are told that a professor says it is easy to increase body pH simply by drinking baking soda.

The results of the mice experiments mentioned above show something completely different. There was an increase in tumour pH, but not of body pH. Our guess is that this is a misquote that wasn’t caught at proof reading. Not only is it inconsistent with Robey’s results, it is also inconsistent with what we know about the normal systems that keep body pH within a very narrow range.

So to summarise:

1) The article is not about clinical trials on sodium bicarbonate as cancer treatment.
2) An increase in tumour pH does not destroy cancer, but it may enhance effects of chemotherapy.
3) The best explanation of the statement that drinking baking soda can increase pH of the body, is that it is a typo.
4) Reduction of amount of new metastasis by drinking baking soda seems like a possibility, but hasn’t been unequivocally proved to happen.

It is claimed that the idea is backed up by hard core science – the Warburg effect, which landed the discoverer the Nobel Prize.

Today we know and understand that things are more complicated than that.

In this post we will attempt to simplify the biochemistry/physiology involved and explain why the idea of a sugar depleted diet as cancer treatment doesn’t work in the real world.

What is sugar?

When we think about sugar, most of us think about the white powdery substance that is used to add a sweet taste to various foods. But it is a bit more complicated than that. The white powder is a compound called sucrose, which is chemically bonded glucose and fructose.

We also ingest sugar in other forms. Lactose for example is present in milk, and is chemically bonded glucose and galactose. Starch found in vegetables and seeds are large molecules made of chemically bonded glucose.

Details of sugar chemistry and manufaction is outside the scope of this post, but here is a good site if you are interested.

What do cells meet when they meet ingested sugar?

The sugar we eat (or drink) is not absorbed by the body just like that. It has to be broken down  to its building blocks first. So for sucrose to be absorbed it has to be split into glucose and fructose, which are then absorbed into the body.  Lactose is split into glucose and galactose etc.

So the the cells are exposed to these small building blocks  - or monosaccharides if you will  (glucose, fructose etc.) – regardless of the food source.

For the remainder of this post we will focus on glucose, because glucose metabolism is what the cancer-feeds-on-sugar myth is about. But it should be clear by now that cells do not distinguish between glucose from refined white sugar or glucose from other food sources.

What does a cell do with glucose?

Glucose is a major source of energy in the cells. This happens through a series of chemical reactions, where the energy in sugar is transformed into a compound that the cells can use.

This compound is called ATP. It’s a fancy word, but just think of it as the currency of energy. The more ATP, the more energy.

Glucose is also a major source of building blocks used in synthesis (construction) of other molecules that the cells need.

Inside the cells, there are three consecutive separate systems, which gradually break down the glucose molecules, thus harvesting the energy contained as well as building blocks for other molecules. These three processes are called glycolysis, citric acid cycle and oxidative phosphorylation.

It is beyond the scope of this post to go into details about these processes, but if you are interested, you only need to follow the links. We will just list a few important points.

• Glycolysis happens in all cells.
• Citric acid cycle and oxidative phosphorylation only happen when oxygen is available.
• Glycolysis generate 2 ATP molecules per glucose molecule.
• Citric acid cycle + Oxidative phosporylation - 28 to 30 ATP molecules per glucose molecule.

So the energy that can be retrieved from a glucose molecule is far greater when oxygen is available compared to lack of oxygen.

When oxygen supply is insufficient, the end product of glycolysis (pyruvic acid) is transformed into lactic acid, which accumulate in the tissue. You may have experienced this yourself during exercise. The muscle ache that develops is a result of this.

Where does all this talk about the Warburg effect fit in?

Otto Warburg looked into glucose metabolism in cancers, and he observed correctly that cancers produce energy predominantly by glycolysis (with accompanying production of lactic acid) – even when oxygen is available. Far from all the energy that could be harvested from glucose is actually harvested and as a result, the amount of glucose used by cancer is very high (up to 200 times normal). This is called the Warburg effect.

So the production of building blocks happens at the expense of a less efficient energy production.

This phenomenon has practical use today. In a PET-scan, areas of glucose uptake is visualised. And because of the Warburg effect, cancers are (often) seen as areas of high level of glucose uptake.

The Warburg affect is no reason to assume  that a sugar depleted diet is the cure for all cancers

The simplicity of the concept makes it easy to understand why people find it plausible that a sugar depleted diet kills cancer cells.

But since Warburg made his discovery, at lot more about cancer biology  as well as normal biology is understood. Let’s outline a few main points, and then decide if the theory is as plausible as it sounds.

1) Cancer is not a ball of cells that are identical in every aspect.

Not only is there large variation between cancer cells, but they also interact in very complex ways with the normal cells that are components of the tumour as well. The complexity of this interaction is illustrated below. It is a figure in  in this (very technical) article.

None of this was known to Warburg, and none of this is addressed by people who advocate sugar depletion as an alternative cancer treatment.

It has been established that:

• Not all cancer cells within the same tumour exhibit the Warburg effect.
• Sometimes it is the normal cells within a cancer that exhibit the Warburg effect.

2) Warburg effect can also be observed in normal cells outside the setting of cancer.

Cells of the immune system and stem cells also exhibit the Warburg effect. So shutting down cells access to sugar is certainly not going to strengthen the immune system. And it will not help the body when it needs to use stem cells to replace old worn out cells.

Inflammation (with the accumulation of cells of the immune system) is a well known source of false positive PET scans.

3) Some types of cancer do not show up on a PET-scan.

This suggests that some cancers do not exhibit the Warburg effect.

4) Glucose degradation is not the only kind of metabolism that takes place inside a cancer cell.

It has been established that fatty acid metabolism and breakdown of Glutamin are very important in cancer cells.

5) Glucose is stored as glycogen within the body

When more glucose than the body needs is ingested, glucose is stored as glycogen. Glycogen production happens more or less in most cell types, but the muscles and liver are the major sites of glycogen stores. When needed, the glycogen is transformed into glucose again.

The stores in the muscles are used by the muscles, while the stores in the liver is used to maintain a stable level of glucose in the blood (which is where the cancer as well as the rest of the body gets its glucose from).

6) Glucose can be made from scratch from other other molecules.

Quite a number of molecules can be used to produce glucose. The most important are lactate, glycerol and alanin (an amino acid = a building block of protein). Most other amino acids and some types of fatty acids can also be used. This is very important, because this helps the body maintain a fairly stable blood glucose level regardless of dietary supply. This graph shows what happens to the blood level of glucose and other substances during starvation:

The blue line shows that the blood level of glucose does decline, but glucose never disappears completely. The red line shows that the level of ketone bodies increase. Ketone bodies can be used as an energy source instead of glucose. But in contrast to claims, ketone bodies cannot completely replace glucose. At most ketone bodies may deliver up to 50% of the brains energy supply. The rest comes from glucose. So a complete elimination of glucose from the blood is incompatible with life.

If you are interested in further details, this article is recommendable.

Have scientists at least explored the possibility of attacking the Warburg effect?

The answer is yes. With a high rate of glucose consumption by many cancers, it is not difficult to understand why researchers want to know if this is a mechanism that could be attacked, and perhaps improve cancer treatment further.

In principle there are two useful ways that this mechanism could be attacked:

1) Reduce/eliminate intake of glucose intake through diet.

This is an idea that has been researched and is being exploited in some types of alternative cancer therapies. The principle is that a low supply of dietary glucose eventually leads to a degradation of fat into fatty acids and ketone bodies instead of glucose degradation. This type of diet is called a ketogenic diet. However a ketogenic diet or even a completely sugar deprived diet cannot completely eliminate glucose from the blood. Furthermore ketone bodies cannot completely replace glucose as fuel for the brain. Ketone bodies may deliver up to 50 % of the brains energy supply. The rest comes from glucose.

Most of what we know about the effect of a ketogenic diet on cancer comes  from animal experiments, but there is some evidence from experiments on human cancer patients too:

In one study, the researchers compared the effect of a ketogenic diet and a glucosed based diet respectively in 27 patients who had cancers of the digestive tract. They measured the proportions of cancer cells that were dividing in each group. If a ketogenic diet was effective, you would expect a lower proportion of dividing cancer cells in samples from this group. They couldn’t detect any statistically significant differences.

In another study, the researchers were interested in the quality of life of 16 patients with advanced metastatic tumours and no conventional therapeutic options. The patients were placed on a ketogenic diet which was intended to last for three months. They found:

• 1 Didn’t tolerate the diet and dropped out within 3 days
• 2 Died after 2 and 5 weeks respectively
• 1 Stopped after 2 weeks due to personal reasons
• 1 felt unable to continue the diet after 4 weeks
• 5 Stopped after 6,7 and 8 weeks respectively because of cancer progression
• 1 Had to discontinue after 6 weeks to resume chemotherapy
• 5 completed the 3 month ketogenic diet period

The latter 6 reported an improved emotional functioning and less insomnia, while several other parameters of quality of life remained stable or worsened.

A case report on 2 patients with a type of brain cancer called astocytoma was encouraging. One of the patients did improve, and the cancer didn’t progress for 12 months.

Clinicaltrails.gov lists several trials looking into this.

So a ketogenic diet may be beneficial to some patients, but it is not a cure for cancer.

2) Medication that interferes with the Warburg effect.

Discovery of new aspects of cancer biology opens up new possibilities for development of cancer destroying drugs. The Warburg effect is certainly an interesting possibility. One such drug under investigation is called Dichloroacetic acid commonly abbreviated as DCA. The mechanism is that shifting from aerobe glycolysis (ie. the Warburg effect) to citric acid cycle + oxidative phosphorylation promotes self destruction of cancer cells through apoptosis.

There are claims put forward by proponents of alternative cancer therapies that this is an effective treatment for  all cancers, and that it is backed up by research done in Canada.

There have been promising results in cell cultures and rodents. But not in all cancers. In one study researchers found that DCA decreased rather than increased apoptosis under hypoxic conditions. This translates into that DCA protected these cancer cells instead of destroying them.

But still the findings in cell cultures and rodents have been sufficiently promising to proceed to testing in humans.

A study including five patients with glioblastoma multiforme (a type of brain cancer) was published in 2010. These these patients also had various other types of treatments, so the study doesn’t really say anything about the efficacy of DCA.

Other misunderstandings in alternative cancer therapy related to the Warburg effect.

As explained above, the Warburg effect is about degradation of glucose resulting in production of lactic acid in the presence of oxygen.

A) Lactic acid

The production of lactic acid leads to a low pH (acidic environment) in the vicinity of the cancer cells. This phenomenon has lead to the reasoning behind some alternative ideas, namely that cancer can’t thrive in an alkaline environment.

The production of lactic acid inside the cancer cells causes an excess of hydrogen ions which will decrease pH inside the cancer cell. Cells, cancer cells as well as normal cells, can’t live with a low pH inside. For cells (including cancer cells) to be able to maintain their lives, they have to get rid of these excess hydrogen ions. There are numerous transport mechanisms that help cancer cells do just that. The extrusion of hydrogen ions leads to a lower pH in the vicinity of the cancer, but this is a result of what goes on inside cancer cells and not a condition for cancer cells to survive!

B) Oxygen

The phenomenon that glucose is degraded through glycolysis without proceeding through citric acid cycle and oxidative phosphorylation even when oxygen is available has inspired the idea that oxygen is toxic to cancer cells. Some quacks advocate use of hyperbaric oxygen chambers for prevention/treatment of cancer. Some even claim that Otto Warburg was awarded the Nobel Prize for the discovery of this, and this is supposed to prove them right. But we have already explained what it was that Warburg discovered – no need to repeat.

It is correct that too much oxygen is toxic to cancer cells. But too much oxygen is just as toxic to normal cells. If you are interested in further details about the damage too much oxygen can do to the body, you may find this wikipedia entry informative.

What are the main conclusions?

• Cells don’t distinguish between glucose (a sugar) from different sources
• Large amounts of glucose are often – but not always – used by cancer cells
• Large amounts of glucose are sometimes used by normal cells
• Consequently, a sugar depleted diet is not a cure for cancer

What is homeopathy?

Homeopathy, originated by Samuel Hahnemann in the 18th century, is a system of medical treatment based on the use of minute quantities of remedies that in larger doses produce effects in healthy people similar to those of the disease being treated (“the law of similars”). Homeopaths believe that very small doses of a medication (“the law of infinitesmals”) will have very powerful healing effects because their potency can be increased by vigorous and methodical shaking (homeopaths call this process “dynamization” or “potentization” of the remedies by means of “succussion”).

Homeopathy’s main principles  have  remained unchanged, while  our understanding of physiology (how the body works) and physics has evolved and increased tremendously. From present day understanding of physiology we know that homeopathy has no biological basis, but this was not self evident 200 years ago.

Homeopaths like to call homeopathy a “holistic” system, but this is a misnomer. A homeopath prescribes remedies based on symptoms and the more symptoms you have, the more remedies will be prescribed. It is a symptom based system in the extreme, not a holistic system, and since it occupies itself only with symptoms, it does not address the cause of the disease.

As said, one core principle is that the effect of a remedy gets stronger the more the remedy is diluted (and shaken vigorously: “succussed”). From present-day knowledge, we know that nothing else in nature gets stronger when diluted – or succussed, and most homeopathic remedies are so diluted that not even a single molecule of the original substance can be found.  Sometimes homeopaths use a lesser degree of dilution, which means that the remedy may contain minute amounts of the original substance.

Nowadays many homeopathic remedies are administered as pills. At some point in the manufacturing process, a drop of water (the diluted and succussed remedy) is dripped onto the pill, which is then left to dry. Today we understand that when the pill is dry, the water has evaporated.

But the absurdities don’t stop there. Through a process called grafting, the acquired capabilities of the dried sugar pills can be transferred to other dry sugar pills; all that is needed is physical contact between a dried sugar pill, and the sugar pills that are to acquire the same capabilities.

Could homeopathy still work?

Many “absurd” ideas have been accepted in the past after passing fair tests. Could this happen to homeopathy too? Actually, homeopathy failed many fair tests. It has been tested so extensively that it is fair to conclude that there is evidence of absence, not just absence of evidence.

Is the homeopathic remedy Psorinum an effective cancer treatment?

No, it’s not.

Let’s take a closer look at Psorinum – and the evidence that is supposedly accepted by ASCO. What we will look into is this published paper  and the presentation given at the ASCO conference in 2009.

The 186 patients in the study had been diagnosed with inoperable cancers of the stomach, gall bladder, pancreas or liver. The patients also had various types of supportive treatments, both conventional and in the form of various homeopathic remedies. Ten  of them dropped out of the study and opted for conventional treatment instead.

We are told that psorinum is an alcoholic extract of scabies: pus cells. Such an extract may indeed still contain some minute biological active substances. This is explained in a blog post here.

We are also told that the remedy used was a “6x-dilution”. This means that the psorinum was in a 1 to 1ooo.ooo dilution. So this remedy may actually have contained some biologically active substances. The patients ingested the remedy, but it is not clear if they drank it, or took pills. Again – a dried pill is a pill where the water has evaporated.

Tumour response was evaluated using CT-scans, and the patients were followed up via personal meetings, phone calls, and emails. One of the things they were asked was whether they had been taking any other conventional or investigational cancer treatments. If they answered yes, they would no longer be offered the homeopathic treatment.

A significant number of the patients experienced shrinkage of their tumours, and 5-year survival rates were approximately 40%. Such figures are indeed impressive. But was it really the Psorinum therapy that was working?

Well – we do know that there are long-term survivors of these types of cancer through conventional medicine. And the only way we know that these patients did not receive any conventional or other experimental treatment is, that they told the researchers so.

There is an interesting graph that is not in the printed article, but only in the oral conference presentation:

This is a way to illustrate survival statistics. The higher the graph, the more survivors. Allopathy is the term homeopaths use for conventional treatment. So the yellow curve represents those who had psorinum and conventional as well as homeopathic treatment. The green curve represents those who had psorinum and conventional supportive treatment, and the magenta represents those who had Psorinum and homeopathic supportive treatment.

The yellow and the green curves are really not all that different. We really can’t tell if the small difference is statistically significant. But the magenta curve is definitely different from the others. It appears that conventional treatment is necessary for homeopathy to work.

There is one important question that can’t be answered from the data: How would these patients have fared on conventional treatment (or allopathy if you will) alone? This is because the researchers never bothered to include a group that had conventional treatment only.

The hypothesis that homeopathy shortened the lifespan of this group of patients is just as valid as the hypothesis that it prolonged it.

If we take the absurdities of homeopathy and the qualified research into account, odds are however, that it didn’t do a damn thing.

What else could be wrong with the study?

As we said, these survival statistics look impressive. So it is reasonable to ask ourselves if there could be anything in the study, that would make it more impressive than it really is.

We can’t know for sure, because the whole dataset isn’t available. But there are some other possibilities that aren’t all that far fetched.

1) Perhaps some of the patients didn’t really have cancer.

The only thing we are told about age distribution is that the patients were between 18 and 86 years old. With the exception of liver cancer, these cancers are rare in people younger than 40. Elderly people without cancer will most likely live longer than people with cancer, but it is not all that implausible, that they would die of old age within the observation period.

The diagnoses were based on either biopsies or fine needle aspirations. According to the study design, none of them were operated, so what we need to take into account here is the possibility of false positive biopsies/fine needle aspirations. Fortunately false positive biopsies are rare, but they do occur. See for instance this study.

2) Another thing we can ask is how reliable the stagings were. The stage is a way to describe how advanced the cancer is. The higher the stage, the more advanced. The most advanced stage is stage 4, where the cancer has spread to other locations. The lower stage, the longer expected lifespan. Cancers do not progress at the same speed. Some cancers grow slow while others grow faster.

We are told that some of the cancers were stage 2 and 3 cancers. Stages are defined differently for different cancers. Since none of them was operated, we only have the radiologic examinations. So what we have to take into account is the possibility of radiologic overstaging. This is a review of radiologic staging of stomach cancer. The researchers went through all publications they could find were radiologic staging was compared to the pathoanatomical stage found in the subsequently surgically removed tissue. In all of these studies, overstaging by CT-scans was found in up to 28,4 % of the cases. So overstaging is a distinct possibility in a study like this one.

3) Was the tested treatment the only one used? The homepoathic treatments used are described in details. The so called “Allopathic supportive treatments” less so. Also the information that they did not receive any other treatments was not based on chat reviews. It was based on information given by the patients during interviews. What would you answer, if you really wanted to try psorinum alongside conventional/experimental treatment of a cancer with a poor prognosis?

So what about all the fuss?

The thing is that there is a big difference between presenting data in a peer reviewed research paper and at a conference. In a peer reviewed paper, the submitted paper has been read by a group of “experts” chosen by the editor. The job of these reviewers is to check if the paper is relevant for the journal and if the study design and results warrant the conclusion that the authors draw from it. Based on their assessment, they may recommend that the paper is published or that changes will have to be made.

An abstract for a conference presentation is also reviewed, but only to check if the study is relevant for the conference. No attempts are made to check if the conclusions are consistent with the study design/results. Here is the abstract from which ASCO accepted the presentation. Not easy to spot that this is about homeopathy. And it is not easy to spot why (based on the data) the conclusion that

Psorinum therapy is effective in treating stomach, gallbladder, pancreas, and liver cancers….

is just as valid as our suggestion  that:

Psorinum therapy reduces the efficacy of conventional supportive treatment of  stomach, gallbladder, pancreas, and liver cancers….

Or the more likely conclusion

Psorinum therapy has no effect on stomach, gallbladder, pancreas, and liver cancers….

So a presentation at an ASCO conference does not mean an endorsement by ASCO.

Many websites including this blog explain what is wrong with alternative cancer treatments and why they are dangerous and there are horrible examples of what happens to patients who chose to forgo conventional treatment and opt for some kind of alternative treatment instead. But the internet is littered with testimonials touting the successes of miraculous alternative cancer cures that are often claimed to be suppressed. Such testimonials can be very persuasive, especially if the reader/video viewer is afraid and not aware of what to look for, so it is no wonder that people get confused.

One type of reasoning we see is:

“you can always try the alternative treatment first, and if it doesn’t work you  can then just have the conventional treatment” .

In this post we will show why that is a very dangerous idea.

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Success stories and horror stories are not that informative in the big picture as long as they are not backed up by reliable research. Therefore, systematic follow-up on patients who receive one or the other treatment and compare which group fares best, is much more informative and that is basically what is done in clinical trials.

Ideally we would want a randomised trial where an alternative cancer treatment was compared to conventional treatment. A randomised trial is one where neither the patient nor the doctor decide which patient get which treatment, for in this kind of trials the groups of patients who receive either treatment are as similar as possible, in order to generate reliable outcomes. However, in this case, such a trial is neither practical nor ethical: patients who despise/mistrust alternative therapy would not take part in such a trial and people who really don’t want conventional treatment should not be forced to have it because of a randomisation number.

Three studies that follow cancer patients who chose alternative cancer treatments only

Fortunately there are other ways of doing systematic follow-up. There are a few studies where the researchers tracked down all cancer patients they could identify who had chosen treat their cancer with alternative treatments only. They could then compare what actually happened to them to what could have been expected had they chosen to undergo conventional treatment.

We have been able to locate three such studies, published in 2006, 2011 and 2012 respectively.

2006: forgoing or delaying surgery or chemotherapy significantly increased progression and death

In 2006 this study was published and it has also been analysed by Orac. The researchers identified 47 patients who were diagnosed with breast cancer and chose alternative treatment instead of conventional treatment. The researchers were able to do a follow-up on 33 of them. What they found was that the risk of progression/death significantly increased – most notably in those who refused surgery, but also in those who refused additional radio-chemotherapy. Not in a single case did the cancer even shrink.

As Orac puts it in his analysis:

This study strongly suggests that forgoing or delaying surgery or chemotherapy is at the very least associated with a significantly decreased chance of recurrence-free survival. The authors do note that it is impossible to tell whether this increase in mortality was solely due to delay or refusal of effective therapy or whether the modalities chosen were deleterious. My guess is that it was almost certainly due to the ineffectiveness of the alternative therapies chosen.

2011: more patients, longer follow-up time, but results of alternative cancer treatments again dismal

This study from 2011 originates from the same institution as the 2006 study. The 2011 study includes more patients and longer follow-up time. The findings are similar to the previous study, but let’s have a look at some of the data in more detail.

In all they identified 61 patients with breast cancer who rejected conventional treatment upfront. Of these, 26 of these refused surgery, 35 had surgery but refused additional hormone, chemo- and/or radiotherapy.

Of the 26 patients who refused surgery, 25 had progression of their cancer, while 1 remained stable during the follow-up time. At the time of diagnosis the median tumour size was 2,0 cm. This means that half of the tumours were smaller and half of them were larger. At the time of follow-up, the median tumour size was 7,8 cm.

This photo is from the article. The patient had chosen diet and herbal therapies instead of surgery. At the time of diagnosis 11 months earlier, the size of this tumour was 2 cm.

Based on various factors such as tumour size, hormone receptor status etc. it is possible to estimate survival. An online tool can be used, and was in fact used in the 2006 study as well as in this one.

For those who chose to completely forgo surgery, no less than 63,6% had died at median follow-up time of 33 months. Had they chosen standard treatment, an estimated 69,5% would have been alive after 10 years.

Things were a little bit better, but not good enough for those who delayed surgery. At median follow-up time of 58 months, 60% were alive.  Had they chosen standard treatment, estimated 10-year survival rate was 73,6%.

As in the 2006 study, the impact of refusing additional radio-/chemotherapy was less pronounced. It was possible to follow-up on 29 patients who chose to forgo additional treatment. Of these, 25 experienced a recurrence. Only 4 patients did not  experience a recurrence during follow-up.

2012: forgoing systemic therapy significantly increased risk of cancer recurrence

This study was published in a journal called Complementary Therapies in Medicine. It is a bit different from the above described studies. This study is part of a larger study called “WHEL”,  where the researchers looked into  the impact of diet on risk of breast cancer recurrence. From this larger study, the researchers identified 177 patients who didn’t receive systemic treatment (ie. chemotherapy and/or hormone treatment). It is not clear from the article how many of these patients had risk factors making systemic treatment adequate, but comparing the information presented in the WHEL study, we assume that the 177 patients were eligible to systemic therapy, but didn’t receive it. This also makes sense since they compare this group to a group in the WHEL population who did receive systemic treatment. The purpose of randomisation in a controlled trial is to make the groups of patients who are being compared are as similar as possible. This is also what is attempted in a study like this one. A careful mathching of the patients who had systemic therapy with the patients who refused in terms of various risk factors for recurrence or death, is a reasonable substitute for a randomised controlled trial. This is what was found in this study:

1) Those who didn’t receive systemic treatment had a 90%  increased risk of  recurrence compared to those who had systemic treatment.

2) Those who didn’t receive systemic treatment had a 70%  increased risk of death compared to those who had systemic treatment.

3) Dietary supplements and/or other alternative treatments had no influence on these risks.

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Studies show that alternative cancer treatments do not work

So what can we learn from such studies? Despite the shortcomings, they are the best we´ve got. So the best available evidence from systematic follow-up of more than 200 patients tells us that the suggestion to “Try the alternative treatment first, and if it doesn’t work you can then just have the conventional treatment.”

really is the worst thing to do.

UPDATE – August 26 2012:

One more study has just been published. This one is from Canada, and the researchers identified 87 patients younger than 75 years who refused primary standard treatment (surgery with or without preoperative radio-/chemotherapy). Patients who refused additional (postoperative) treatments were not included in this study.

For each of the patients who refused treatment, 5 matching patients who had treatment were identified.  The patients were matched by age , calendar year and clinical stage. The purpose of matching patients is to make sure that comparisons between the two groups is as fair as possible. For instance if the group of patients who refused treatment were at a more advanced stage, it is to be expected that this alone would result in poorer outcomes.

Then they reviewed the charts to identify reasons for the patients refusal of treatment. 50 of these patients were known to use alternative therapy instead. It is unclear what the remaining  37 patients did. Some of them may have had alternative therapy – we just have no way of knowing.

30 out of the 87 patients had surgery later on. This table shows what happened to the stages:

In 4 of the patients, the cancers had not progressed. They had so in the remaining 83 patients. Not in a single case did the cancer even shrink.

The researchers also looked into survival statistics.

Such a curve is a way of illustrating differences in survival among groups being compared. The higher the curve, the more survivors. This set of curves tells us that there is a big difference in survival among those who received standard treatment and those who didn’t. 5 years after the diagnosis was made, 18,1% of those who had standard treatment had died from their cancer. Of those who refused treatment 56,8% had died within  5 years. You may also have noticed the “p< 0,0001″ between the two curves. This is a way of telling how reliable this difference in survival is. Some lived longer than others in both groups, so there is always a possibility, that the difference could be the result of chance. The “p-value” is a way of saying how probable it would be for this difference to be a result of play of chance. The lower the p-value, the more likely it is that this difference is real. In medical research, a p-value less than 0,05 is widely accepted as evidence, that the result is reliable.

It would also be interesting to know if those who had alternative treatment fared better than those who just refused to have treatment:

It may be tempting to see this curve as some evidence that those who use “CAM” fare better than those who use “nothing”. But unknown does not equal “nothing”. As mentioned above, some of the patients in the unknown group  may very well have had alternative therapy. Furthermore we have no idea of how the patients in the two groups match in terms of stage etc. And then there is the p-value again. p=0,14 means, that the observed differences may as well be a play of chance. There is no way, it can be claimed that this show survival benefits for those who had alternative therapy instead of “nothing”. And other way to put this is, that having alternative therapy for breast cancer is just as effective as doing nothing.

So the results of this study back up the results of the other studies we have mentioned.

The collective evidence is strong that “Alternative therapy instead of standard conventional treatment for breast cancer is a really bad idea”

Sharing experimental results through publication is a good thing. But it also opens up for all sorts of cancer quackery, where the results are used as definite proof that ideas of theirs work. And the fact that it is not used as conventional treatment is often claimed to be because of some kind of conspiracy. The internet is full of such bogus cures where the evidence consists of a combination of experimental studies and cancer cure testimonials. We could mention cannabis, antineoplastons (more correctly phenylbutyrate) and Graviola.

How good these experimental models are at predicting effects in humans is of no concern to promotors of cancer quackery. But researchers have asked themselves this question, and looked into it.

Before we look more deeply into the results of the researchers efforts we will side step a little and form an overview of the principles in these experimental models.

CANCER CELL LINES
A cancer cell line is simply a cell culture grown in a lab from single cell. A cancer in a patient is not a cancer cell line. There is great variation of the cells within a cancer. And the ways they interact with the surrounding normal cells are also very complex. The American National Cancer Institute (NCI) recommends that a panel of 60 cell lines reflecting different cell types and different drug resistance profiles in the most common types of adult cancers is used for drug screening.

TYPES OF MOUSE MODELS
Four different types of mouse models are used in the initial testing of potential new drugs:

1) Genetically engineered: The mice have specific genetic mutations that result in a high probability that they will develop specific types of cancers.
2) Mice injected with cancer cells originating from mouse cancers
3) Mice injected with human cancer cells under the skin
4) Mice injected with human cancer cells into the tissue that the cancers originate from

None of these models are exactly like human cancers  as they occur in human patients, but they do make sense as models of various aspects of cancer.

HOW GOOD ARE MOUSE MODELS AT PREDICTING EFFECTS IN HUMANS?
Here is a research paper that looked into this question. The researchers looked at the relationship between response to 39 cytotoxic agents in mouse models and subsequent clinical phase II trials.

There was a positive response in a mouse model if the tumour was reduced in size by at least 60 % or the mouse survived at least 25 % longer than untreated controls.

There was a positive response in a clinical trial if the tumour was reduced in size by at least 50 % in at least 20 % of the patients.

This figure summarizes some important results:

Each bar represents one type of cancer that was tested in mice. The height of the bars illustrate how well the effects in mice correlated with effects in subsequent clinical trials. The “*” on top some of the bars indicate that the correlation was statistically significant, ie stronger than what would be expected from play of chance.

From looking at the figure we can readily see a few things:
1) Rarely did a positive response in a mouse model predict a positive response in the same kind of cancer in patients. Only in a lung cancer model did the response correlate to response in lung cancer patients (NSCLC = non small cell lung cancer).

2) Rare did positive response in a mouse model predict positive response in other kinds of cancer in patients. If there was response in mice implanted with breast cancer, there were some response in patients with lung cancer, melanoma and ovarian cancer. And a positive response in patients with melanoma was also seen with drugs that showed positive response in mice implanted with colon cancer.

Another interesting figure is this one:

It shows that if a positive response was found in less than 1/3 of the cancer types in mice, it was unlikely to produce a positive response in human cancer patients.

THE “SUPPRESSED BUT PROVEN” CANCER CURES
The fact that the experimental mouse studies are published in well reputed peer-reviewed journals disproves that research into these things are being suppressed, so we won’t address this idea any further in this post. But let’s take a look at the experimental evidence of some of the “suppressed” cures that are out there:

1) Cannabis:
A study found that THC reduced tumor bulk by only 50% in experimental mice implanted with only one type of cancer cell line. This is being touted widely by cancer quacks as evidence of efficacy of cannabis, but as we have seen it is not possible to draw such a conclusion. Here is an update on the current evidence on cannabis as a potential anti-cancer tool.

2) Antineoplastons:
Proponents of Burzynski sometimes claim that this study is one that independently of Burzynski proves that antineoplastons work. It is a study involving mice with two cancer cell lines. What the researchers found was a reduced growth  rate compared to controls. Not tumor shrinkage. It may be Burzynski independent, but proof it is not. As a side note the active ongoing research into clinical applications of sodium phenylbutyrate (which we now know is the precursor of Burzynskis antineoplastons) firmly disproves that research into this compound is being suppressed.

3) Graviola:
There are a few studies on cultured cell lines. But we did find one study on mice. Again the study involved only one cell line. And only reduced growth rate – not tumor shrinkage was seen.

We think a plausible explanation of why these natural substances have not caught the interest of the pharmaceutical industry is obvious. A substance with so little effect in experimental mouse models is not likely to be useful as cancer treatment. The research funds are better spend elsewhere.

Update: There is another good post about preclinical cancer research on Science-based medicine:  http://www.sciencebasedmedicine.org/index.php/the-problem-with-preclinical-research/

Is Dr. Stanislaw Burzynski legitimate?

This is what lo_mcg answered:

Burzynski claims to cure cancer with extracts from human urine. There shouldn’t really be any need to say more, but here goes.

Burzynski is actually an MD (though his claim to a PhD is apparently dubious); however he had no specialty training in cancer and had no preclinical or clinical cancer research experience when he announced his ‘cure for cancer’ 35 years ago.

 His ”antineoplastons” -the substances he has isolated from human urine which he claims cure cancer – have never been shown to have any effect on cancer; attempts to replicate his claimed results by the National Cancer Institute, the Japanese National Cancer Institute and Sigma-Tau Pharmaceuticals failed.

Be wary of unsubstantiated testimonials about miracle cancer cures. You have no way of knowing whether the person ever had cancer in the first place, much less has been cured. And you have no way of knowing whether, if genuine, they are still alive. This is from Orac’s Respectful Insolence blog:

 ”…Dr. Burzynski first gained fame for his antineoplastons back in 1988, when Sally Jesse Raphael featured four “miracle” patients of Burzynski, who, according to her, had had incurable cancer and failed conventional therapies but were then cancer-free, thanks to Dr. Burzynski.

 Unfortunately, four years later in 1992, Inside Edition followed up these four patients: ‘In 1992, “Inside Edition” reported that two of the four patients had died and a third was having a recurrence of her cancer. (The fourth patient had bladder cancer, which has a good prognosis.) The widow of one of Raphael’s guests stated that her husband and five others from the same city had sought treatment after learning about Burzynski from a television broadcast — and that all had died of their disease. In 1995, a federal grand jury indicted Burzynski for mail fraud and marketing an unapproved drug. The indictment charged that he had billed insurance companies using procedure codes for chemotherapy, even though his treatment was not chemotherapy. He was tried in 1997 but not convicted.’

***EDIT*** Oh looky! A total of 8 answers, all from people who joined YA on the same day specifically to answer this question! Suspicious? You decide!

As the addition to the answer suggests, there was something fishy about some of the other answers.  On the same day eight posters who had all signed up on the same day posted answers praising Burzynski and his treatment. One of these posters called herself “Mary Jo Siegel” – the name also held by the founder of this patient group.

That entry on yahoo answers has been referenced in several places on the internet.  And both the aspects of MAS behavior as well as the sudden simultaneous appearance of eight Burzynski proponents have been in focus.

The other day lo_mcg received a notice from the administrators at Yahoo-answers that her answer had been reported and deleted. Being chosen as the best answer, this means that the question, all other answers and the debate in the comments section were deleted too. No reasons were given, but this can happen if one or more “reliable” users report it as abuse. How reliability is determined is not known.

This is the appeal that lo_mcg filed:

I haven’t been told the reason given for this answer’s deletion. It answered the question ‘Is Dr Stanislaw Burzynski legitimate?’, and is strictly factual. The number of ‘thumbs ups’ my answer has received indicates that a lot of members of the Y!A community found it helpful.

I am concerned that in deleting this answer (and, since it was Best Answer, the whole question and all subsequent debate on the issue) Yahoo!Answers has allowed itself to become a victim of Dr Burzynski’s clinic’s campaign to silence all criticism by any means possible.

The ‘Comments’section following the question is largely taken up by a user called MAS insulting, berating and threatening me and all those who dared speak against Burzynski and his unproven claim to be able to cure cancer. The account ‘MAS’ set up for this purpose was shortly afterward deleted by Y!A after I submitted a series of threatening and insulting emails he had sent me.

MAS was later revealed by many other reputable websites as Marc Stephens, who was employed by the Burzynski Clinic to silence opposition – a job he undertook with zeal by posing as a lawyer, and making sinister threats to bloggers who criticised Burzynski’s practices, including threats to one blogger’s newly-born child and the attempted intimidation of a 17 year old blogger which included a Google Earth picture of his home. The Burzynski Clinic has acknowledged that he was employed by them to oppose and silence criticism.

http://bocktherobber.com/2011/11/burzynski-clinic-supporter-threatens-17-year-old-blogger

http://www.quackometer.net/blog/2011/11/the-burzynski-clinic-threatens-my-family.html

http://anaximperator.wordpress.com/2011/11/26/is-marc-stephens-really-a-representative-of-burzynski/#comment-5295

https://docs.google.com/viewer?a=v&pid=explorer&chrome=true&srcid=0BzijOpjuex1bMjE4N2JjOGItZGFlOS00NDE0LTk2YzktMThkYjFiOTU2YjNl&hl=en_US

The Burzynski Clinic subsequently relieved Stephens of his duties, though he is still connected to the clinic. However, the clinic has vowed to continue their attempts to silence criticism.

By deleting a valid and factual answer on the subject, Y! A is allowing someone to misuse its reporting system in pursuit of this intimidation campaign, and becoming the campaign’s latest victim.

The appeal was denied.

In all fairness, the addition is a violation of the “community Guidelines/Terms of service. One cannot help speculating what Yahoo is afraid of. We feel it is unacceptable that the Burzynski proponents should have the power to silence people, which is why we have chosen to bring lo_mcg’s answer as well as the appeal of its deletion out in public view.

After writing a post on Dr Stanislaw Burzynski, Andy Lewis of the Quackometer received legal threats from someone by the name of Marc Stephens, who claims to represent Burzynski.

This is not the first time this person threatens bloggers in this way. Peter Bowditch of Ratbags.com is another recent example.

The style of his emails does sound a bit lawyerish, but then again – not really.

What we do know is that Marc Stephens is a marketing representative for a Burzynski supporter group – and the Burzynski Clinic does have a link on their website to this group.

But like everyone else, Marc Stephens has a past.

Marc Stephens was heard of as early as March 2011 on Yahoo Answers, a question and answer forum where people can ask and answer questions on a large variety of topics. One of those sections revolves around cancer. There is also one that revolves around alternative medicine. In both of these sections questions on Burzynski appear from time to time and in one of them the poster “lo_mcg” gave a perfectly reasonable answer. Just below the answer there is a “comments button”. If you press that button you will see how the “Burzynski representative to be” behaved. The first thing he did was to reveal an email address which he thought belonged to lo_mcg. We do not know if he actually wrote an email to this unfortunate person. The insults he put forward in public were bad enough, but it didn’t stop there.

He also sent emails to lo_mcg, expecting that she would be the only one to see them. This email exchange took place between March 28 March and April 11. All the emails came through YA’s messaging system , and he was unable to continue his harassment because Yahoo deleted his account. Lo_mcg has offered those emails to the public, and we feel that people should know about Marc Stephens’s recent past. So here is the full email exchange, including the two replies lo_mcg wrote.

From: MAS

Subject: Dr. Burzynski

Reply from lo_mcg:

Your ‘research’ is rather fanciful; no that’s not me. Have you been harassing that unfortunate person with emails and threats?

I left school 42 years ago; never been to med school; never been to Georgia – in fact never been to the US. I’m someone who was desperate to avoid harsh treatments when diagnosed with advanced cancer, and researched all possible options.

I have given no ‘medical advise (sic)’, nor would I ever.I have not ‘defamed’ anybody; in fact the only person I refer to by name is Dr Burzynski.

I have made no comments about any patients of Dr Burzynski. Please reread my answer carefully. The only reference I make to any patients of Dr B is contained within a quote, clearly credited and clearly enclosed in quotation marks.

The only ‘advise’ (sic) I gave was to ‘Be wary of unsubstantiated testimonials about miracle cancer cures. You have no way of knowing whether the person ever had cancer in the first place, much less has been cured’, advice I frequently give in replies on YA and will continue to give to people seeking internet advice on cancer treatment – ANY cancer treatment.

If you want clues for further ‘research’, my YA username is in fact a mixture of letters from my own name and that of my paternal grandmother. And I live in a country that is not the US 

From: MAS

Subject: Re: Dr. Burzynski

Message: “His ”antineoplastons” -the substances he has isolated from human urine which he claims cure cancer – have never been shown to have any effect on cancer”.. It doesn’t matter what country your in unless your on Mars..you can be sued for Defamation of Character, dissemination of false information, and negligence if you give medical advice. Dr. Burzynski has a patent in multiple countries for Antineoplastons and that is your quote above.

If you claim to be educated you should know you can not patent a drug that does not work, or is illegal. If you actually did do research you would know the FDA and the US Government are trying to steal the patent to antineoplaston. In addition, Antineoplaston is being introduced to PHASE III clinical trials? Maybe you should do more research on the matter because you are giving FALSE information. You should also speak with the patients and the kids that were treated successfully visit http://www.burzynskipatientgroup.org. Also, you can watch the NEWS stories on the website. Be responsible and do the research or I will pursue.

Feel free to contact me anytime 562-843-9398 or mastephens1@gmail.com. Many people are unaware that Dr. Burzynski patients are treated and are doing great. Don’t fall pray to propaganda. There is also a movie out (documentary) about Dr. Burzynski which has won numerous awards..I suggest you watch it. Thursday March 31 I am very serious. Thank you Marc Stephens. fyi..Dont think your IP is not tracked. Good night.

***

From: MAS

Subject: Burzynski

Message: You are afraid of facing the truth. If you are as smart as you think watch the documentary.

The type of person you are…you would think all the lawyers, police, and patients were lying in court when they testified in favor of Burzynski.

Then Burzynski won ALL multiple cases against him filed by the Government. But I thought his treatment does not work. The JURY even started testifying and supporting Burzynski. You need to do more research.

Why are you afraid to watch the documentary??? COMMENT on the documentary. I would think that a person that gives advise on cancer would look into current and relevant information. You claim you had cancer. POST your medical records like Burzynski Patients are doing on their website. You are CLEARLY a fraud..as well as the rest of the people on your page.. which is probably you with multiple accounts. I dont believe you… so can you prove that Burzynski is a fraud. I thought you were here to help innocent people like me who want the truth about cancer cures.

THE BURZYNSKI DOCUMENTARY
http://www.youtube.com/watch?v=S81PXHwjMAQ&feature=channel_video_title

***

From: MAS

Subject: Burzynski

Message: For someone that is 58 yrs old who supposedly had breast cancer, and suffer from Diabetes type 2 and Lymphoedema you sure are hard headed and have NO RESPECT for cancer patients. Is that how they raise people in London-UK? Are you afraid to watch these videos:

1. Jessica Ressel Interview Brain Cancer Cured by Dr. Stanislaw Burzynski with NO Chemo or Radiation Therapy.

Jessica followed by media at 11 yrs old http://www.burzynskipatientgroup.org/news/jessica-ressel-brain-cancer

Jessica at 24 yrs old http://www.youtube.com/watch?v=WwTonGa0kCg&feature=player_embedded

2. Kelsey Hill Interview Lung & Liver Cancer Cured by Dr. Stanislaw Burzynski with NO Chemo or Radiation Therapy..6 month old baby.

http://www.youtube.com/watch?v=G0tTt1GO9RU&feature=player_embedded

3. Jodie Gold Fenton Interview Brain Cancer Cured by Dr. Stanislaw Burzynski with NO Chemo or Radiation Therapy.

http://www.youtube.com/watch?v=xNW5afr6vmM&feature=player_embedded

4. Lt. Col. James Treadwell Brain Cancer Cured by Dr. Stanislaw Burzynski with NO Chemo or Radiation Therapy.

http://www.youtube.com/watch?v=tai7oMXw-nY&feature=player_embedded

***

Reply from lo_mcg:

Becoming something of an obsession with you, aren’t I?

All the information you believe you have artfully gleaned is freely available from my YA answers – except  that I was either raised in or live in London, which I wasn’t and don’t.

Please know that I am a person of principle and can’t be frightened or bullied into saying something I do not believe to be true.

If you wish to change my mind about something on which I have formed an opinion, harassment and personal insults are not the way to do it. Rational argument is.

If you read my posts about Burzynski carefully, and are honest, you will see that nowhere have I called anyone a liar or a fraud.

But replication is the proof that something is effective; and Dr B’s results have not been successfully replicated, and so my position remains the same. And yes, I have watched some of the videos you link to.

In your search though my YA contributions, you can’t fail to have noticed that I am actually unfailingly respectful of cancer patients in my answers. If you don’t feel you have seen enough, I will happily add you as a ‘contact’, which means my Q&A will be visible to you. That way you won’t have to waste any more time googling.

Please note that even if I wanted to (which I don’t), I could not now remove my answer

And be aware that I simply don’t care whether you believe what I say or not. I’m adult and secure enough not to spend time fretting about other people’s opinions of me.

I suggest you move on now

From: MAS

Subject: Re: Burzynski

Message: “If you read my posts about Burzynski carefully, and are honest, you will see that nowhere have I called anyone a liar or a fraud.”

Your context insinuates that Burzynski is a fraud and a Liar in the following statements of yours..which is defamation of character.

“Burzynski claims to cure cancer with extracts from human urine. THERE SHOULDN’T REALLY BE ANY NEED TO SAY MORE, but here goes.”

“His ”antineoplastons” -the substances he has isolated from human urine which he claims cure cancer – have NEVER been shown to have any effect on cancer…” Are you sure “NEVER”..?

This is called Defamation – LIBAL which means defamation by written or printed words, pictures, or in any form other than by spoken words or gestures. UK law allows actions for libel to be brought in the High Court for any published statements alleged to defame a “named or identifiable individual” or individuals in a manner that causes them loss in their trade or profession, or “causes a reasonable person to think worse of them”.

You are on Yahoo giving medical advice to THIRD PARTIES which people take your answers as TRUTH. Your statements are 100% incorrect which medical records can prove in court that patients are being cured with Antineoplastons. Its also FDA approved for clinical trials and considered NON TOXIC. So your “NEVER” statement qualifies as defamation. Opinions also fall under defamation..your being NEGLIGENT. yahoo is a PUBLIC forum and BURZYNSKI is a PUBLIC FIGURE. Be smart.

***

From: MAS

Subject: Re: Burzynski

Message: I am just giving you FACTS about your statements. These are not threats nor do I have to bully someone to change their mind or OPINION. I am just letting you know that OPINIONS and false information whether on purpose or being negligent can land you in court. Because you are on Yahoo answering medical questions since 2007 you are looked at as an expert to the average person. There are also other Members telling people to listen to you because you know what your talking about. I have that as well.

I am trying to show you the TRUTH about Burzynski but you seem to be running away. Its unreal being that you claim to have suffered the side effects of chemo, radiation, and surgery. I do respect you, but you have to understand that what you put on PUBLIC forums you are liable for. Dr. Burzynski is a public figure and I can give you numerous cases he filed in regards to this type of action. In addition, he won numerous cases against the government. You really need to stop with your opinion when it comes to medical advice on public forums..you also have no disclaimers.

Call the Burzynski clinic and ask for current statistics of their patients..its avail. Dont you think they would be out of business and in jail providing FAKE statistics for over 30 years?

Wouldn’t you be upset if I told the world you NEVER had breast cancer and you are a fake? All the pain you went through and for someone to make you look like a fool in public..you would be hurt. Feel better.

***

From: MAS

Subject: Burzynski

Message: I see you just dont quit. I was going to take it easy on you. I do investigations for a living. How about you do some more current reading and not from old *** government propaganda newspapers and BLOGS.

You are stubborn which is why god gave you so much pain in your life. God hate ugly as they say. This is also why your comments are filled with ignorance, hate, and lies. you work for the devil now.. Wake up miss cancer patient of the decade. You probably LIED about cancer as well..you need attention.

In the end I will be laughing at all of you psychos. Go drink a glass of chemo..on the rocks. You are psycho but at least you have an excuse. Radiation and chemo turned you out..you no longer think with logic.

I already know your name and address. So good luck if a suit is at your front door. You talk too much thats how I found you. Lol. Be a good girl..hope you dont have pain in your thighs anytime soon..your already a pain in the ***… Lol.

Soon I will contact the patients and the clinic and provide them with your silly statement of “antineoplastons NEVER being effective”..when his drug is CLEARED for FDA phase 3 clinical trials. This trial will test the effectiveness between Radiation therapy and antineoplaston therapy on brain cancer. So you may want to retract your statement. : ) When you stop being childish and ignorant I will do the same. Follow your own medical advice and stop eating junk and exercise to help with your type 2 diabetes. Take care

***

From: MAS

Subject: Burzynski

Message: Hey Lo_mein… Im starting to think Bruce LI, Dave and busted, Gary No, Rhianna does herself, and Tink who cant Think are ALL of your split personalities with its own Yahoo account..Lol! How can so many people be so ignorant..?

Can you all answer this question. Is Antineoplastons approved for Phase 3 clinical trials by the FDA? Yes or No….

***

From: MAS

Subject: Burzynski

Message: Lo_Mein. Can you please answer this since you are the expert on cancer here on Yahoo Answers. Is Antineoplastons approved by the FDA to commence Phase 3 clinical trials?

Phase 1 is it Toxic to humans? NO.
Phase 2 shows positive results? YES.
Phase 3 Effective and ready for Marketability?

***

From: MAS

Subject: Burzynski

Message: Just in case you didn’t read Yahoos Terms of Service.

You agree to not use the Yahoo! Services to:

upload, post, email, transmit or otherwise make available any Content that is unlawful, harmful, tortious, AND DEFAMATORY;

intentionally or unintentionally violate any applicable local, state, national or international law;

You acknowledge, consent and agree that Yahoo! may access, preserve and disclose your account information and Content if required to do so by law or in a good faith belief that such access preservation or disclosure is reasonably necessary to: (i) comply with legal process;

You agree to indemnify and hold Yahoo! and its subsidiaries, affiliates, officers, agents, employees, partners and licensors harmless from any claim or demand, including reasonable attorneys’ fees, made by any third party due to or arising out of Content you submit, post, transmit, modify or otherwise make available through the Yahoo! Services;

SOME JURISDICTIONS DO NOT ALLOW THE EXCLUSION OF CERTAIN WARRANTIES OR THE LIMITATION OR EXCLUSION OF LIABILITY FOR INCIDENTAL OR CONSEQUENTIAL DAMAGES. ACCORDINGLY, SOME OF THE ABOVE LIMITATIONS OF SECTIONS 19 AND 20 MAY NOT APPLY TO YOU.

I knew you would be searching for me so I answered the Spurs to let you know your acting like a COWBOY..slang for a Reckless person who ignores potential risks. Pretty smart huh?

You can offer to amend your statement..before I submit to yahoo. NEVER is a bad word when Phase 3 is FDA approved to commence.

***

Threats like this: “Thursday March 31 I am very serious.” can be frighthening, but as lo_mcg mentions:” March 31st came and went 8 months ago”

We would like to express our support to Andy Lewis, lo_mcg, Peter Bowditch and everyone else who has refused to yield to this sort of behaviour.

Update:

UPDATED 27.11.11:
The connection between Marc Stephens and The Burzynski Clinic appears to have been confirmed: 17 year old blogger Rhys Morgan received a legal threat similar to that of others, and in the process he contacted the Burzynsci Clinic for confirmation of this connection. The reply came from Marc Stephens:

… I represent Dr. Burzynski, the Burzynski Clinic, and the Burzynski Research Institute. I’ve attached Azad Rastegar, and Renee Trimble from the Burzynski Clinic for your confirmation.

This means that all the ridiculous legal threats and all the contempt for people with cancer expressed by Marc Stepehens were expressed on behalf of Burzynski.

UPDATED 30.11.11:

The Burzynski Clinic issued a press release regarding the recent internet activity.

See also:

Summary of information on Burzynski by Josephine Jones.

UPDATED 7.12.11
A blogging lawyer is looking into the legal aspects of Marc Stephens’s threats. And he has been in contact with him.
UPDATED 21.12.11
There has been further contact between MAS and Popehat.

UPDATED 1.3.12
If you thought Marc Stephens would silently slip into oblivion you thought wrong.

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”.

TESTIMONIAL 1:

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.

TESTIMONIAL 2:

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 4.5.2.4 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.

TESTIMONIAL 3:

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.”

Conclusion

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.

Related posts:
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.

Adams claims the various chemotherapy and radiation treatments Jobs underwent, both in the USA and abroad, brought about his death, implying that had he not done this, he would most certainly have been alive and healthy to this day. Curiously though, what Adams fails to mention is that Jobs, after he was first diagnosed with a rare form of pancreatic cancer, decided to forgo conventional treatment and tried to cure his cancer with an alternative food regime. Apparently the results were dissappointing, for after about nine months of alternative therapy he had his tumour surgically removed. Outlook after surgery can be quite good, provided the tumour is removed before it has had a chance to spread to other organs.

We don’t know whether the delay in standard treatment caused the cancer to spread; it may have, but then again, it may not have. What we do know is that Jobs survived for almost eight years after his diagnosis, which, to all intents and purposes, is impressive when it comes to pancreatic cancer, and that he did this with the help of standard cancer treatments.

Steve Jobs died on Wednesday, October 5 2011, at the age of 56

This was typed on an Apple MacBook – the best computer I ever had.