Alternative Medicine and Cancer

 

 

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                                                                       Coley's Toxins   

Coley's Toxins were once widely used within conventional medicine.  It, or quite likely a toned-down version of it ,  is now only offered by some alternative clinics.   

 I learnt about Coley's toxins in medical  school!   We were told how doctors noticed that cancers occasionally went into remission after a major febrile (feverish) episode.    Coley used the toxins of certain bacteria to mimic such a febrile response and found cancers sometimes seemed to respond to this treatment.  

Coley developed his treatment in the late 19th century but controversy concerning it persisted for over half a century.   A controlled trial was finally performed and published in 1962.  To some extent this  resolved the matter in favour of Coley's toxins,. although a single trial cannot be regarded as the final word.  

I sent this (slightly edited) summary of the paper to a newsgroup.   

" Judging from the references in this paper this is the only controlled trial that was ever done on Coley's toxins, even though they had already been in use for a remarkable seventy years.  It appears that some were claiming results which others could not replicate, but that some effect was being also reported in animal studies of cancer.

This is an extraordinarily well performed trial, even using an "active placebo" in the form of typhoid vaccine  in the control patients, which is remarkable for a trial performed in 1962.    The authors can hardly be faulted for the rigour with which the trial was done. .(The placebo was required because they were also looking for symptomatic benefits from the treatment).

 Nine out of 34 patients in the treated group appeared to show objective benefits (i.e. cancer remission) , but none at all in the untreated group.    One patient with  a recurrent giant cell tumour of the thyroid had   a complete response and was free of cancer four years later.  Eight other patients had partial or brief remissions but two of these were lost to follow up very shortly afterwards (one died of accident). The rest died of their cancers or with their cancers in from three months to three years. 

This supports what we were taught in medical school about Coley's toxins, that some cancers probably do respond to them, but with no regularity or predictability.

If a cancer patient has few other options and is keen to try an alternative,  this could be worth a few week's trial.    However, I advise caution. The method used in this study was that of  doctors  very experienced in its use.   The   toxin was made from Streptococcus  Pyogenes and Serratia Marcescens.    The dose was carefully adjusted according to the febrile (feverish) response to a daily injection  The treatment had to produce a  fever of between 102 and 104 degrees with chills lasting 20-30 minutes, and it was given for five days with a two day rest.   It was continued more or less indefinitely in those showing response, making it a rather arduous program of treatment.  

There is no certainty that what is offered as Coley's toxins by some alternative clinics is comparable.."

Despite this study the method died out within conventional circles.  Why?   I  suspect that by this time more reliable results were being observed with some types of cancer from the emerging chemotherapies. They were simpler to use, they didn't have to make the patient sick nearly all the time, and they did not require constant medical attention.  Some kinds of cancer were also being regularly brought into remission and occasionally cured for the first time.

Also Warburg had recently shown that cancer cells tend to use anaerobic rather than aerobic metabolic pathways. This is now known to not be crucial to their survival -- cancer cells grow quite well in tissue culture when exposed to the ample oxygen in room air, and even hyperbaric oxygen fails to stop cancer (putting hydrogen peroxide with its much weaker ability to raise oxygen levels in the "highly implausible" category of alternative  treatments) .   Nevertheless this discovery was hailed at the time as a major advance, being the very first biochemical difference ever to be demonstrated between cancer cells and normal cells.

I suspect these developments. along with the recent spectacular successes of antibiotics against bacterial infections, induced a climate of optimism that left little enthusiasm for such a now well-tried but fickle treatment method as Coley's toxins. There is no good reason that I can see why it might not have persisted as something to try as a rather desperate  last resort.

Interestingly,  some conventional chemotherapeutic agents are bacterial toxins (adriamycin, bleomycin). .     

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