The Problem With Chemotherapy
An increasing number of scientists over recent years have dared to speak up regarding the obsolescence of chemotherapy. Although their hope is usually for adequately targeted gene therapy, which is a dead-end, as explained in Chapter 9 of Manifesto for a Cancer Patient, it is an acknowledgment of the unacceptable problems of chemotherapy. I have even heard a number of chemotherapy oncologists admit this in medical conferences in small conversations with their colleagues. Dwight McKee MD is one of the few medical oncologists to go on record with this prediction.i
Modern chemotherapy was born in World War II, November 30, 1943, in Bari, Italy. The event was an air attack by the Luftwaffe on Allied warships. Unfortunately, one such ship was stockpiled with an agent of chemical warfare: mustard gas, despite an agreement by both sides not to use war gasses. As Allied servicemen found themselves blown from their ship and into the now contaminated water, an oily residue clung to their skin and clothes. Over the next few days, following rescue from the cold water, they complained of burning skin and blindness. One thousand Allied servicemen lost their lives from this exposure.
Over the next few days after the attack it was discovered that another effect of this gas exposure on the men was that their white blood cells were greatly reduced. Later, the same chemical was then given deliberately and experimentally to lymphoma and leukemia patients, and it was discovered that their cancer burden regressed considerably. This discovery was especially exciting, because conventional medicine had not yet offered any effective treatment at all for any cancer, except for radical surgery and radiation. Neither of those was applicable to such an elusive and scattered blood disease, such as the leukemias. So here was something that appeared to be a viable and promising alternative.
But the excitement was short-lived, because the cancer regression only lasted weeks. The nitrogen mustard in mustard gas attacks DNA, which greatly inhibits cell reproduction.
However, and this is the problem with chemotherapy generally, cells mutate, and are all too soon resistant to the chemotherapy drug that they were exposed to. So the cancer grows once more. But this time, the cancer is a bit less vulnerable. The cancer has seen its attacker and endured and in some non-conscious way (of course), has “learned” from it. I tell my patients that it is a similar situation to taking too little of an antibiotic. By teasing bacteria with too little of an antibiotic, or too-short dosing, you have trained it to become stronger and more resistant. This is obviously not a desirable situation when managing infectious disease. Why then should we allow cancer to learn and fortify itself from our mistakes?
An equally serious problem is that anti-DNA strategies of cancer treatment inevitably hurt the entire body. With conventional dosing of chemotherapy, initially, nausea and vomiting wrack the body. All of the cells of the blood: red and white blood cells and platelets drop to dangerous levels. The GI tract from mouth to anus becomes excoriated with scattered bleeding, as this normally quickly reproducing tissue is stopped from producing more tissue. Finally, after a few weeks the hair cannot make new cells, and the already produced hair falls out.
Much has been made of this loss of hair as being the only horrifying effect of chemotherapy, yet in essence a merely cosmetic inconvenience. However, if you see such drastic destruction as this overall alopecia – no head hair, no eyebrows or eyelashes, and all the way down – on the surface of the body, what kind of destruction do you suppose is taking hold on the inside? Given these devastating effects, is it really any surprise that an agent of war, a chemical poison, was the first chemotherapy agent used?
Later in 1947, methotrexate was developed. Having learned from the temporary remission, relapse and then ultimate failure of the nitrogen mustard in leukemia, scientist Sidney Farber looked for a way to interfere with folic acid use or uptake by the body. Folic acid was necessary for proper DNA function and normal cell replication. Farber wanted a molecule that looked a little like folic acid by the body, enough to be attempted in use by the cells. However, what he mostly wanted was a molecule that would gum up the works, a Trojan horse into a cell. Methotrexate was similar enough to folic acid to be accepted by all the necessary receptor sites, but not similar enough to function adequately as folic acid. Therefore, like the mustard gas, it stopped cell division, and it led to the same devastating effects, with only temporary remission from leukemia.
In 1951, 6-mercaptopurine (6-MP) developed by scientist Gertrude Elion, performed a similar function. As with the two predecessor drugs, remission could be achieved, but only for weeks.
With these three, however, Sidney Farber’s goal of amassing an arsenal of multiple chemotherapy drugs was beginning to be realized. That is, Farber had written of inspiration from recent productive developments in antibiotics. A strength of the new arsenal of antibiotics was to have multiple weapons with which to defeat a multi-faceted problem: bacterial resilience. The thinking was that when one antibiotic weakens a bacterium, the next one in a therapeutic series may be likelier to finish the job.
Farber dreamt of a similar arsenal for chemotherapy, enough weapons to be able to eliminate cancer for good. Or at least an ability to switch from one agent to another in the face of resilient cancer growth.
As it turned out, this was later achieved in an area that Farber never thought of looking: the natural world. However, Otto Warburg, who had figured out the nature of cancer over a decade earlier, would likely not have been terribly surprised.
In 1957, two colleagues, Emil Frei and Emil Freireich, were able to realize Farber’s goal of combining chemotherapy drugs for more intense impact. Methotrexate and 6-MP were each quite harsh drugs alone. Now in combination, they were so toxic as to bring cancer patients, in this case, children with leukemia, to the brink of death. However, that toxicity also was somewhat effective against the cancer. Remission rose from less than 20% to 45%.ii
But the price paid for that increase was morally reprehensible: a slow poisoning of children compounding the misery of their already devastating disease. How could their doctors put them through such torture?
Oncologist Max Wintrope of the National Cancer Institute Hospital observed that “These drugs cause more harm than good, because they just prolong the agony. The patients all die anyway.” iii In this bleak environment, the goal was to rid the body of every single cancer cell, in the belief that even one such cell remaining in the body could bring a return of the cancer throughout the body.
Yet the combinations of chemotherapy drugs multiplied, with Freireich’s strategy of combining drugs of different types of toxicity, so that a child with leukemia was not attacked so harshly in one particular organ system, but rather with the misery spread throughout the body.
In the 1960’s chemotherapy and the field of oncology generally was new, with the first of that field including Frei, Freireich and Vincent DeVita, a cardiologist who joined them in 1963. At the time, they were very much outsiders in the medical field, viewed askance and skeptically by their colleagues who disapproved of the severe toxicity of chemotherapy. Yet each time a cocktail of chemo drugs was given to the children with leukemia, their leukemia at first abated and then came back, usually to the brain, where it was not so accessible to any known treatment, and gradually the patients of the three researchers died of recurrent leukemia. However, by the end of the sixties, with even larger combinations of drugs and targeted to the neurological system, where the leukemic cells were sequestered, children with leukemia were finally going into remission.
Thus chemotherapy entered its long heyday. It seemed that with appropriate combinations of drugs, childhood leukemia could be put into remission. The zeitgeist in the early 1970’s was, more than anything else, confidence. A man could walk on the moon. And finally, cancer, one of the most devastating diseases in human history, was being held at bay by pharmaceutical innovation. The budget for drug development at the National Cancer Institute grew to $ 68 millioniv and vetted 40,000 drugs every year. The standard mechanism for the drugs was the same very time: tangling DNA into an unworkable knot, so that cell reproduction was prevented. This stopped all growth, including cancer, and led to the familiar side effects of hair loss and GI tract excoriation, as well as damage to major organs.
James Watson, co-discoverer of the DNA double-helix, and physician/author Eric Topol spoke out against the indiscriminate destructive forces of the chemotherapy regimens, which held the patients on the edge of life and death. He and many others questioned the ethics of delivering the patient to the brink of death, in order to pound the cancer as hard as possible. As a result, Watson was quickly sidelined from those front lines, getting kicked off the advisory board of the National Cancer Institute.
But despite the criticism, NCI’s position grew bolder. Instead of only targeting leukemia and other blood dyscrasias, NCI pushed for also using the toxic cocktails with solid tumors, which accounted for the majority of cancer deaths by far.
When the results of all this intervention were finally tallied by statisticians in the mid-1980’s the numbers were bleak. Death by cancer had actually increased by 9%. Then more bad news surfaced by the 1990’s regarding the survivors. Those treated for Hodgkins lymphoma were 18 times more likely to later develop secondary cancers, and 75 times as likely to develop breast cancer as patients never treated for lymphoma.
This disappointing news renewed calls among the public and the scientific community for more precisely targeted therapies, chemotherapy that could be more of a ‘magic bullet.’
That particular prescription was expected by all to be filled by conventional medicine. It wasn’t. It is beginning to be filled by natural medicine, as we will see in Part Two.