QUESTIONABLE CANCER PRACTICES IN TIJUANA AND OTHER MEXICAN BORDER CLINICS



The following is a review and summary of information on "Metabolic Therapy" as provided in Tijuana and other Mexican border clinics. Although some of these methods are offered in the United States, Tijuana, and several nearby communities commonly offer a variety of cancer treatments under the common name of metabolic therapies.

A wide variety of methods may be placed under the heading of "metabolic therapy" because the focus is more on the body's function or condition than on the specific treatments per se. Some popular examples of these therapies are:
  • Injections of hydrogen peroxide
  • Large quantities of pressed liver and carrot juice
  • Coffee enemas
  • Doses of Laetrile mixed with massive doses of vitamins and dimethylsulfoxide (DMSO)
  • Special diets

Unfortunately, no evidence exists that any of these methods are more effective than no treatment at all.


How Is Metabolic Therapy Promoted for Use?

Modern "metabolic therapies" are based on 3 main ideas:
  • The belief that poor diet and the build-up of toxins from foods, additives, and environmental pollution are the main causes of chronic diseases. This claim is without scientific basis. While it is true that there have been some connections made between diet and disease, the actual number of cancers related to diet remains unknown. Food additives, such as artificial colors and preservatives, are also claimed to cause cancer. But evidence is lacking that such products are a major threat when used properly. Likewise, some industrial pollution has been linked with a higher number of some tumors. But the levels that most people are exposed to do not appear to present a widespread hazard. Things that are found in nature, such as sunlight, can cause cancer. Experts have said that this threat from nature is often greater than the threat from pollution and additives.
  • The belief that removing toxins from the body (detoxification) and dietary changes can reverse diseases. Scientific evidence is lacking that proves that removing certain foods or other substances from the diet or environment will change the outcome of active cancer once it has become established. So, while dietary changes may be helpful to a cancer patient, there is no proof that these will cure cancer.
  • The belief that tumors can and do thrive without oxygen and are killed by substances that increase the oxygen supply to the tumor. The idea that cancer cells thrive under low levels of oxygen is based on observations that the rates of respiration in tumors are below normal. However, modern researchers credit the reduced respiration rate and lower oxygen levels in tumors to the poor blood supply and lack of blood vessels in tissue surrounding rapidly growing tumors. Thus, there is no current scientific reason for the use of specific products such as hydrogen peroxide and ozone that are claimed to kill tumors by raising levels of oxygen in the blood (hyperoxygenation or oxymedicine).


What Is the History Behind Metabolic Therapy?

The exact origin of the term "metabolic therapy" is not clear. Miller and Howard-Ruben attribute the concept to German-born Dr. Max Gerson, who developed a treatment in the 1920s based on bowel cleansing and dietary changes. Gerson brought his treatment to the United States in 1938, where he practiced until his death in 1959. His work was carried on by his daughter, Charlotte Gerson Strauss, who established the Gerson Institute in 1977.

In the late 1960s, 2 other promoters started treating patients with their forms of metabolic therapy. William Donald Kelley, a dentist from Washington state, wrote that he believed that cancer was indicated by pancreatic enzyme deficiency. His tests for cancer included the questionnaires called the Kelley Enzyme Test and the Kelley Index of Malignancy. In 1970, Dr. Kelley was convicted of practicing medicine without a license, and in 1976 a court suspended his dental license for 5 years. It was at Kelley's Clinic, south of Tijuana, that actor Steve McQueen was unsuccessfully treated for mesothelioma in 1980.

Ernesto Contreras, a medical doctor, originally set up a clinic in Tijuana where he promoted Laetrile injections as a cancer cure-all. Eventually he added the other aspects of metabolic therapy to his treatment in the form of vitamins, enzymes, and detoxification. It should be noted that Laetrile use is illegal in the United States.

Another form of metabolic therapy was developed by Harold Manner, PhD, a former zoology professor from Loyola University. In addition to standard detoxification and oral vitamin and enzyme doses, Manner's therapy includes daily "Manner Cocktails." These are infusions of vitamins A and C, Laetrile, and dimethylsulfoxide (DMSO). Although Manner died in 1988, his version of therapy is still offered at a hospital named for him in Tijuana.

Otto Warburg, MD, became famous for discovering specific respiratory enzyme complexes and was awarded the Nobel Prize in Medicine 2 times. As noted above, a metabolic approach was developed to supposedly increase oxygenation of cancer cells based on Warburg's theory that cancer cells can function without oxygen and can be destroyed by high levels of oxygen. This view was also held by Max Gerson.


What Does Metabolic Therapy Involve?

Most metabolic therapies share common beliefs about the cause and progression of disease. But, their applications of the various forms of therapy vary widely. The discussion that follows is general and shows the most common practices. Most promoters claim that standard medical practitioners treat only the "symptoms" of disease while they, on the other hand, address the underlying cause of disease.

Most metabolic therapies have 3 basic steps:
  • Detoxification
  • Strengthening the immune system
  • Use of special modalities to attack the cancer
Detoxification

Detoxification refers to the removal of so-called toxic agents from the body using methods such as diet restriction (fasting), enemas, chelation therapy, rectal infusions of wheat-grass, and removal of mercury-amalgam fillings.

Diet restriction: Metabolic therapy regimens often begin with a restricted diet or a fasting period, 3 days being common. To reduce the risk of fluid and mineral (electrolyte) imbalance, small amounts of juices or other foods may be provided. More information on diets is provided below.

Enemas or colonics: Enemas may be administered as frequently as every 2 hours supposedly to facilitate the removal of toxic build-up in the bowel. These may be standard enemas or high colonics, a procedure involving the use of nozzles connected to tubes that reach high into the colon. The claim that colonic irrigation will improve the intestine's ability to digest food reflects a basic error in understanding the human anatomy. Almost all of the nutrients are absorbed in the small intestine, the twenty-foot tube into which food passes after leaving the stomach. The digested material then enters the large intestine. The main function of the large intestine is to absorb water and a few minerals. The belief that detoxification will improve absorption of nutrients by the large intestine is false.

Special enema solutions may also be used to help in the cleansing process. Examples are:
  • soap suds, claimed to help get the bowels moving (Manner)
  • coffee, claimed to detoxify the liver (Gerson); herbal laxative mixtures (most clinics)
  • hydrogen peroxide (Donsbach)

Chelation therapy: The FDA has approved chelating (binding) drugs to remove poisonous buildups of metals such as lead, mercury, cadmium, and zinc. The chelating agent circulates in the bloodstream and attaches to the heavy metal molecules, helping to remove them from the body in the urine. As a metabolic method for cancer treatment, chelation therapy is claimed to block the production of a group of harmful molecules called free radicals (unstable oxygen molecules, which can cause cell damage). There is no scientific evidence to support these claims.

Chelation therapy is given intravenously. Sometimes it is given as an infusion of ethylene diamine tetraacetic acid (EDTA) that drips into the vein over a period of 3 or 4 hours. A typical treatment cycle may include 20 injections or infusions spread over 10 to 12 weeks. Chelation therapy can also be given by mouth. Because the therapy removes some important minerals from the body, patients often receive vitamin and mineral supplements during treatment. Practitioners recommend a minimum of 20 to 40 treatments initially; however, some may recommend continued therapy for up to 100 treatments over a period of several years.

Risks: Extended periods of fasting, although no longer recommended at most of the clinics, are still used as parts of some metabolic regimens. Risks from detoxifying methods include:
  • Electrolyte imbalance, dehydration or death from fasting even a few days when combined with other ways of detoxification
  • Rupture (perforation) of the colon
  • Transfer of harmful infections between patients by unclean enema devices
  • Inflammation (colitis) caused by additives to enemas such as soap suds, paint thinners, ground ginger, pepper, and ash
  • Nausea
  • Diarrhea
  • Flu-like symptoms
  • Severe cramps from the enemas
Colonic therapy should not be used in individuals with ulcerative colitis, diverticulitis, Crohn's disease, hemorrhoids, intestinal tumors, those prone to infection or those taking blood thinners.

Strengthening the Immune System

Another phase of metabolic therapy is alleged to strengthen the immune system by using special diets and specific immune system enhancers.

Diet: Diets range from poorly balanced vegetarian regimens to ones that are well balanced and nutritionally adequate. Diet is used by metabolic practitioners not only to strengthen the immune system, but as part of a lifestyle change designed to restrict intake of new toxins. Specific diets are tailored to correspond to each patient's metabolic profile as determined by the questionable diagnostic tests described above.

The edible components of the dietary regimens furnished at the inpatient clinics, although not necessarily ideal for cancer patients, are generally adequate and fairly well balanced. A notable exception is the highly restrictive Gerson diet.

Foods commonly promoted are those that are "natural" and "organic." These include such items as:
  • Fertile eggs
  • Certified raw milk
  • Sea salt
  • Yogurt
  • Carob
  • Kelp
  • Garlic
  • Wheat grass juice

Foods considered unacceptable are those that have been processed or homogenized, or those that contain additives and/or preservatives.

Nutritional supplements are a major part of most metabolic therapies. Large numbers of supplements are routinely suggested. Supplements are claimed to balance the diet, help restore the patient's normal metabolic patterns, strengthen the immune system, and destroy tumors.

Commonly included are:
  • Large doses of vitamins, especially vitamins A, C, and B complex
  • A variety of minerals including calcium, potassium, magnesium, selenium, and zinc
  • Enzymes to reduce tumor growth and aid digestion
  • Glandular (organ) extracts, promoted to boost the affected organ system (for example, liver extract for liver cancer, lung extract for lung cancer, etc.)
  • Other products including para-aminobenzoic acid, carnitine, lecithin, inositol, RNA, DNA, amino acids, injections of animal organ cellular extracts, and a number of herbs and herbal products

Immune system stimulants: In addition to advocating nutritional supplements, metabolic therapists also recommend the use of products they claim will stimulate the immune system. Most of these are unproven, such as gerovital (procaine hydrochloride plus vitamins) and "hepmare plus" (a shark liver extract). Some drugs however, are being used or studied today. Examples are Bacillus Calmette-Guerin (BCG), (an anti-tuberculosis vaccine not widely used in the US), gamma globulins, and interleukins.

Risks:
  • The use of unpreserved and inappropriately processed foods may expose patients to unnecessary risk of infection. Foods like raw milk have been linked in numerous cases of sickness and death, especially in patients whose immune systems are compromised.
  • The diets recommended to outpatients vary and often do not supply enough nutrition. Foods claimed as natural and organic have not been demonstrated to differ nutritionally from other foods and, therefore, do not justify the additional cost.
  • The massive levels of supplements, costing as much as $1,000 per month, can place patients at risk since the high doses of supplements may be toxic or disrupt metabolic balance when used in doses exceeding the recommended dietary allowances (RDA). In some cases, patients on metabolic regimens have been hospitalized because of this.
  • Glandular substances and enzymes are, for the most part, digested when eaten and are therefore useless for treating diseases or controlling symptoms. Also, laboratory tests have shown some products, especially those taken from animals, to be contaminated with dangerous bacteria.
  • Experimental drugs, such as interleukins and immunoglobulins used at the Mexican clinics, are not given under clearly defined protocols, as required by responsible research methods. Sometimes, one form of a drug may be used inappropriately to treat cancers for which only the other form has proven effectiveness. For example, using alpha interferon instead of gamma interferon.
  • In some cases patients may not be given the drugs they are told they are receiving. So, patients may be misled into believing that they are taking medication that has been proven to be effective.

Attacking the Cancer

Finally, metabolic therapies are claimed to attack and destroy tumors. Various tumor-specific substances are promoted and sold with the claim that they are effective, natural, and non-toxic. A few of the more popular agents include:
  • Urea, based on the idea that urine has cleansing powers
  • Cesium chloride, claimed to inhibit cancer growth by making the pH of cancer cells "basic" instead of acidic
  • Hydrazine sulfate, said to destroy tumors
  • Germanium sesquioxide and hydrogen peroxide, sold as hyperoxygenators
  • Laetrile, claimed to poison only cancer cells
  • Low dose chemotherapy

Few of the dozens of products promoted as anti-tumor agents by metabolic therapists have been approved for use by the U.S. Food and Drug Administration, even as experimental drugs. Several, such as Laetrile and germanium sesquioxide, have been tested and found to be not effective or toxic. The hyper-oxygenators have no demonstrated benefits, and both hydrogen peroxide (administered enterally and parentally), and ozone (administered rectally) can be harmful because of excess free radical production and oxidation of tissue. Several clinics use low dose (micro-dose) chemotherapy in combination with metabolic therapy. The claim that this reduces side effects while still being effective has not been shown to be true.

Also considered useful are modalities such as prayer, Bible study, sing-along sessions, imagery, exposure to colored lights, "bioelectrical stimulation," and the use of various magnetic devices.


The Role of Metabolic Therapy in Diagnosing Cancer

Traditional medical diagnosis includes standard tests such as blood chemistry tests or checking the level of carcinoembryonic antigen (CEA) in the blood. In contrast, the metabolic therapy uses tests that are of questionable scientific value. Examples are tests to measure strength (applied or nutritional kinesiology), hair analysis, iris diagnosis (iridology), the Navarro Urine Test (a test for the hormone chorionic gonadotrophin), the AMID or AID test (Arthur Metabolic Immunostatus Differential or Arthur Immuno-status Differential), live cell analysis, block crystallization, and Donsbach's Nutrient Deficiency Test. Unscientific tests such as these are used at these clinics to diagnose current problems and monitor patient progress, as well as to predict susceptibility to disease in the future.

Although some standard diagnostic tests may be used, metabolic practitioners do not necessarily use recognized norms when deciding the significance of test results. Harold Manner, for example, taught his students that blood chemistry values within the normal range could indicate mineral deficiencies. Ernesto Contreras inappropriately used CEA values, which can be affected by factors other than cancer, as primary indicators that colorectal cancer patients need his therapies. All the tests commonly used by metabolic practitioners to establish "metabolic standards" have been demonstrated to be useless or lacking scientific rationale. Especially noticeable is the lack of biopsies evaluated by competent pathologists.

Patients arriving at the Mexican facilities may be asked to bring their medical records, but these records are not considered necessary, because the treatment protocols employed at the clinics do not follow those set up by standard medicine.


Costs

Patients at the clinics can expect to pay $2,500 to $4,500 a week for their stay plus travel expenses. Some clinics have additional costs for extra treatments, and companions are charged $200 to $300 a week to share the room with the sick relative. The recommended stay is often several weeks. Outpatient programs often cost $1,000 to $2,000 a week. Most programs also recommend follow-up therapy at home for additional fees, and some patients may be urged to return to the clinics for additional treatments.


Recommendations

It is difficult to fully and precisely evaluate the metabolic therapies described above. For the most part, the concepts lack reasonable scientific rational or logic. On the other hand, some practitioners use modalities that have a basis in responsible science, so it is difficult to say that all aspects of these therapies are useless. Also, because the hundreds of regimens claimed to be metabolic in nature change almost daily, any full evaluation would be outdated almost immediately.

None of the metabolic therapies has been demonstrated to be safe or effective in treating forms of cancer that are incurable by approved methods. There have been many instances where patients taking metabolic therapies were kept from timely, effective treatment, resulting in needless deaths.

Patients traveling to the Tijuana area for metabolic treatments appear to be subjecting themselves to costly and hazardous regimens, especially if they forego responsible medical care. Few of the metabolic practitioners have been specifically trained in oncology. None of the therapies has been tested utilizing the safeguards put in place by the scientific community to determine effect and to ensure that any benefits outweigh the risks, and no evidence of effectiveness other than lay literature and patient testimonials has been provided to qualified researchers.

The American Cancer Society urges individuals with cancer to seek treatment from qualified cancer care professionals who can offer cancer treatments that have been proven to be safe and effective or that are currently being studied in clinical trials.


References

American Cancer Society's Guide to Complementary and Alternative Cancer Methods. Atlanta, Ga.: American Cancer Society; 2000.

American Cancer Society. Unproven methods of cancer management. The metabolic therapy of Harold W. Manner, Ph.D. CA Cancer J Clin 1986;36:185-189.

Barrett S, Herbert V. Questionable cancer therapies. Quackwatch Web site. Available at: http://www.quackwatch.com/01QuackeryRelatedTopics/cancer.html. Accessed March 15, 2002.

Gonzalez NJ, Isaacs LL. Evaluation of pancreatic proteolytic enzyme treatment of adenocarcinoma of the pancreas, with nutrition and detoxification support. Nutr Cancer.1999;33:117-124.

Green S. Nicolas Gonzalez treatment for cancer: gland extracts, coffee enemas, vitamin megadoses, and diets. Quackwatch Web site. Available at: http://www.quack-watch.com. Accessed May 8, 2000.

Murphy GP, Morris LB, Lange D, eds. Informed Decisions: The Complete Book of Cancer Diagnosis, Treatment, and Recovery. New York, NY: Viking; 1997.

University of Texas Center for Alternative Medicine Research in Cancer. Therapies not reviewed. University of Texas-Houston Health Science Center Web site. Available at: http://www.sph.uth.tmc.edu/utcam/summary/greentea.htm. Accessed May 8, 2000.

US Congress, Office of Technology Assessment. Unconventional Cancer Treatments. Washington, DC: US Government Printing Office; 1990. Publication OTA-H-405.



Revised: 04/16/2002 12:00:00 AM

 
 
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