For May 2, 2002
I Is for Immunotherapy When I went to work for Memorial Sloan-Kettering Cancer Center
in June 1974, the big excitement was over immunotherapy. This means
treating diseases such as cancer by altering the body's own defense
mechanisms. Robert A. Good, MD, PhD, had just been made president
of Sloan-Kettering and was on the cover of Time touting the wonders
of immunotherapy. A new day seemed at hand, with our nation's recently
launched "war on cancer" being fueled by billions
of dollars in research funds. As a fledgling science writer, I naturally turned my attention
to this exciting topic. Sometimes I did this to the exclusion of
surgery, radiation and chemotherapy. I couldn't help it. Immunotherapy
seemed so much more promising than the "cut-burn-and-poison"
school, which failed to cure about half the patients. At that time, immunotherapy was not fully respectable. The American Cancer Society maintained a list of "unproven methods of cancer management," and immune methods were among those this organization deemed unorthodox and therefore suspect. Incredibly, one prominent figure on their list was the late William B. Coley, MD, who had been a famous bone surgeon at Memorial Sloan-Kettering from the 1890s to the 1930s. Dr. Coley had developed an early form of immunotherapy using bacterial products that had apparently benefited quite a few cancer patients. In 1975, I visited his daughter, Helen Coley Nauts, at her apartment on upper Park Avenue. It was a visit that changed my life. Helen Nauts was a formidable lady. (She died in January 2001 at the age of 93.) No stranger to controversy, she had founded the Cancer Research Institute of New York to rescue her father's work from oblivion. It was she, along with her friend Lloyd Old, MD, vice president of Sloan-Kettering, who engineered the removal of Coley's toxins from the ACS list in 1975. Mrs. Nauts wrote over a dozen scholarly monographs on the treatment of cancer using her father's methods. The detailed accounts of remissions were impressive, although I suspect that most of these books have gathered dust on library shelves for the last 25 years. Off the record, Helen told me a hair-raising story of the skullduggery that had prevented the acceptance of her father's innovative methods. What shocked me most was that this promising treatment was unavailable in the United States. We had launched a "war on cancer," but one which seemed focused on finding new patentable drugs rather than exploring therapies with the greatest potential, regardless of their origins. Was it possible, I wondered, that Coley's toxins had been neglected because they were unpatentable and too darn cheap to make money for drug companies? Many insiders hinted as much. This line of reasoning led me, five years later, to write The Cancer Industry (1980), where I told the story of Coley's toxins for the first time for the general public. There is no question that the field of immunotherapy has flourished since then. There are over 25,000 articles on cancer immunotherapy in PubMed, the National Library of Medicine's database of medical journals. But only about a dozen of these articles discuss Coley's toxins per se and none of these is a proper clinical trial. In 1999, Dr. Maryann Richardson, then of the University of Texas, wrote an excellent review, in which she concluded that "patients treated with surgery and Coley's toxins between 1890 and 1960 experienced survival rates comparable to those of patients diagnosed in 1983 and treated with... conventional approaches." Get that? Patients who were treated in the Gaslight Era with a form of immunotherapy fared as well as those who are treated in modern times with conventional methods. Nowadays, Coley is honored as the godfather of immunotherapy. (See,
for example, Stephen S. Hall's book, A Commotion in the Blood.)
But the effects of Coley's innovative form of immunotherapy
are either ignored or misrepresented. So please do not write
me asking where to get Coley's toxins. There is not a single hospital
in the United States that administers them. Most doctors are ignorant
of their existence. What is needed is a full-scale randomized controlled
trial to compare the effects of Coley's bacterial toxins to conventional
treatment. This was the dream of Helen Nauts. But it will remain
a dream until independent patients and their advocates call the
shots in national policy instead of the profit-oriented drug industry
and its many representatives. A Follow-up on FishOn April 2, I wrote about the many health benefits of fish, including its protective effects on the heart. Subsequently, two articles in top journals confirmed these claims. The first was a study of 22,000 male doctors. Researchers compared physicians who had died of sudden death from heart disease to others in good cardiovascular health. In particular, they compared bloodstream concentrations of omega-3 fatty acids, which are found primarily in fish oils. The men who had the highest levels of omega-3s had only one-fifth the risk of sudden death as those who had the lowest levels. A second study, in the Journal of the American Medical Association, looked at the health records of 85,000 female nurses. Researchers found that the more frequently a woman ate fish, the less likely she was to suffer a heart attack or to die of heart disease. Those who ate fish once a week had a 30 percent lower risk of heart attack or death than those who never ate fish. Both studies strongly support what I wrote several weeks ago: fish
is an essential food for maintaining a healthy heart. (As
I mentioned in that article, it protects against cancer as well.)
I try to eat some form of seafood, preferably fatty fish, twice
a week. However, you need to be aware that many fish are contaminated
by mercury, and try to select those types that are least polluted.
The worst offenders are large predatory fish such as shark, swordfish,
king mackerel, tilefish, and very large tuna (sold
as steaks or sushi), while the safest fish are haddock,
cod, hake, flounder, pollock, Atlantic salmon, herring, smelts,
clams, shrimp, scallops, lobster (except
the tomalley, which can contain dioxin) and canned "light"
tuna (safer than canned "white"
tuna). The safest freshwater fish are brook trout,
yellow perch and landlocked salmon. Despite the risks, fish remains
an essential food for preserving health. Here at the Moss ReportsFor those of you who read Danish, my article on chocolate's health properties appears in the April 2002 issue of Tidslerne, the journal of an outstanding Scandinavian association of cancer patients (Kraeftforeningen Tidslerne). Email: tidslerne@mail.tele.dk. There has been an increase in media interest in the "War
on Cancer." This is the normal lead-in to the American
Society of Clinical Oncology (ASCO)
meeting next month. In the last few weeks, I have given interviews
to the Boston Herald, San Diego Union,
etc. I hope to be at the ASCO meeting in Orlando in mid-May
and to bring back news of some of the latest developments in oncology.
--Ralph W. Moss, Ph.D. Sources:On Coley's toxins:
Moss RW. The Cancer Industry. State College, PA: Equinox Press, 1996. On fish and heart risk: Hu FB et al. Fish and omega-3 fatty acid intake and risk of coronary heart disease in women. JAMA 2002;287:1815-1821. Albert CM et al. Blood levels of long-chain n-3 fatty acids and the risk of sudden death. N Engl J Med 2002;346:1113-1138. Collins R et al. The MRC/BHF Heart Protection Study: preliminary results. Int J Clin Pract 2002;56:53-56. **NOTE** To view this page in a more printable format, please CLICK HERE. IMPORTANT DISCLAIMERThe news and other items in this newsletter are intended for informational purposes only. Nothing in this newsletter is intended to be a substitute for professional medical advice.
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