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A New Hypothesis on Spontaneous Remission of Cancer
Part 1: Introduction
This is a copy of an e-mail I received, with a hypothesis which deserves serious consideration.
Briefly, Coley's Toxins had a very good success rate of about 50%. While that is far, far higher than conventional chemotherapy (about 2.5%), it wasn't 100%. This doctor suggests a reason why.
Hello Barry Groves
Let me start of by introducing myself. My name is Joseph Thuo and I live in Nairobi, Kenya. I recently came across the work of Dr William Coley while researching on obsolete medical therapies. I find it very hard to believe that an effective therapy in the form of Coley's toxins has been ignored by most researchers for many decades. I think the main problem is the fact that many people consider it to be an immunological therapy. However the efforts of cancer immunologists have yet to solve the problem regarding the toxins' unpredictable efficacy. After going through some of the cases of spontaneous remission I have realized that the fever induced by the infectious agents should be the focus of any theory regarding this miraculous phenomenom. Since fever is a metabolic factor, other factors contributing to spontaneous regression should also be primarily metabolic. Anyway, to keep it short I have formulated a theory regarding spontaneous remission which also tries to explain selective efficacy of Coley's toxins.
Introduction
In medical terminology, spontaneous remission of cancer refers to the unexplained and sudden disappearance of all signs and symptoms of cancer. This rare and mysterious phenomenon has been observed physicians for several centuries. Many anecdotal cases have been recorded in modern medical literature.
A number of theories have been proposed to try and explain the obscure mechanisms responsible for spontaneous remission. The most popular theory postulates that the immune system causes spontaneous remission. Another theory suggests that hypothyroidism slows down the growth of cancerous cells. Other researchers think DNA modulation plays a key role in cancer remission. The truth is, no one has come up an undisputable scientific explanation for spontaneous remission of cancer.
Some people may ask why is it important to understand spontaneous remission? The main reason researchers should be interested in spontaneous remission is that it could pave the way for new and more effective therapies to treat cancers. It offers a solid basis of hope and firmly establishes nature's willingness to yield its secrets of cancer healing.
Most cases of spontaneous remission are often preceded by acute febrile infections. There are many documented cases of cancer that underwent spontaneous regression after acute bacterial infections e.g. streptococcal or staphylococcal infections. A study carried out by Kleef et al for the office of Complementary and Alternative Medicine [NIH, Bethseda] concluded that the occurrence of fever in childhood protected against the later onset of malignant disease and that spontaneous remission is often preceded by febrile infections.
The incidence of spontaneous remission has been estimated to range from 1:60,000 to 1:100,000. Despite the existence of such an amazing natural phenomenon there is currently very little research focusing on spontaneous remission. The impression I get is that cancer researchers do not consider this topic serious enough to warrant a thorough and conclusive study.
Coley's toxins
One doctor who decided to take the phenomenon of spontaneous remission seriously was Dr. William B. Coley, an eminent New York surgeon. He spent most of his career working at Memorial Hospital [now Memorial Sloan-Keterring Center] He was convinced that there was a more effective way of treating cancer after witnessing the disappointing results of surgery; the standard treatment of solid tumors at the time. He started his search by going through all the records of sarcoma patients at the hospital. To his surprise he came across the case of a German immigrant that had undergone spontaneous remission, after the doctors treating him had declared his cancer terminal. This regression had occurred after a severe attack of erysipelas. Coley searched the east side of New York for the man and found him in apparently good health more than seven years after his "miraculous" healing.
Coley was inspired by this particular case and he decided to experiment with Streptococcus pyogenes the bacterial organism that causes erysipelas. His initial aim was to induce spontaneous remission after inoculating the patient with erysipelas. However, he later decided to use non infectious by products of Streptococcus to minimize the risk of death in his patients. He also discovered that by combining the products of Streptococcus pyogenes with those of Serratia marcesens he could produce a more potent vaccine. The classic Coley's toxins, was a mixed bacterial vaccine containing both endotoxins and exotoxins. Coley's toxins administered in adequate doses caused an acute immune reaction similar to that produced by an acute bacterial infection. The clinical symptoms observed in patients injected with the vaccine were fever, chills, rigors, joint pains and general malaise.
Coley and his colleagues in Europe and America treated thousands of cancer patients.
His daughter Helen Coley-Nauts collected his records and summarized the outcome of 900 microscopically confirmed cases. The five-year survival rate for this particular group of patients was found to be 50%. This proves that Coley's toxins achieved excellent clinical results that exceeded the efficacy of the current treatment modalities. Even staunch critics of the vaccine admitted that a number of hopeless cancer cases were completely cured by Coley's toxins.
However despite these achievements the use of Coley's toxins began to decline after his death in 1936. Eventually the Food and Drug Agency declared that Coley's toxins were ineffective in the treatment of cancer. As a result of the FDA's decision in 1963 it became illegal to use and produce the vaccine in America . This decision was primarily due to the fact that Coley's toxins produced very unpredictable clinical results in cancer patients. Despite the fact that hundreds of patients experienced complete remissions, the vast majority of patients with malignant disease did not respond at all to the toxins. Another factor that contributed to the demise of Coley's toxins is the lack of theoretical basis that could fully explain it's selective efficacy. Since no one knew how it worked no one could improve its efficacy. The discovery of "more effective" therapies in the form of radiotherapy and chemotherapy diverted human and financial resources. These new therapies produced more consistent clinical results and were easier to understand scientifically. Last and not least economic factors also helped to push Coley's toxins out of the list of mainstream medical treatments, into the twilight zone of alternative therapy. This was mainly due to the fact that the various components required to produce Coley's toxins were readily and cheaply available. Therefore most pharmaceutical companies decided to channel their resources into researching and manufacturing chemical compounds that could be patented. This led to the birth of the powerful multibillion dollar chemotherapy industry.
However despite the fact that use of Coley's toxins in cancer treatment is no longer considered to be an effective option, a small number of researchers are still fascinated by the dramatic results achieved in some patients. However one scientific fact that not disputable regarding the positive clinical benefits observed in some patients, is the presence of fever; i.e. the patients who had high fever had significantly higher rates of remission than those who had mild fever or no fever at all.
Current research
Research regarding Coley's toxins focused mainly on the immune system. Immunologists began with the assumption that one of the chemicals produced by the cells of the immune system during an acute immune reaction was responsible for the vaccines efficacy. The race to identify the "active" factor produced in response to Coley's toxins was on. Chemicals produced by the immune system cells to modulate its activity are known as cytokines. Numerous cytokines have been discovered since the 1950s. These include Interleukin-1[IL-1], IL-2, IL-6, IL-8, IL-12, Interferon gamma, macrophage colony stimulating factor and tumor necrosis factor. Some of these cytokines have marked anti-tumor activity, which has been clearly demonstrated in in-vitro studies as well as in laboratory animals. However clinical trials in humans using specific cytokines in combination with chemotherapy or as a monotherapy have produced disappointing results. These poor results have been obtained despite the fact that very high doses of cytokines have been used in these clinical trials when compared to the levels usually produced by the body's natural response. In recent years immunologists have redirected their efforts towards identifying specific antigens produced by malignant cells only. Some of these antigens, which provoke a limited immune response have been well characterized. However despite these promising laboratory studies a crucial clinical breakthrough in cancer vaccination is still missing. In other words the various immuno-therapeutic modalities in use today have not made a significant impact in the lives of most cancer patients. This has not surprised most immunologists since the primary function of the immune system is to protect the body from invasion by foreign organisms; i.e. infectious agents. It is therefore rather obvious that although Coley's toxins cause an immune reaction it is not the immune system that is responsible for the tumor regression. This has convinced another group of researchers to concentrate their efforts on the fever produced by the mixed bacterial vaccine. Scientists have discovered that high temperatures may help shrink tumors. The National Cancer Institute is currently undertaking studies to determine the efficacy of local, regional and whole body hyperthermia in cancer treatment. Local hyperthermia refers to heat application to a small area. This can be done using an implanted microwave antennae or externally using high frequency waves. Regional hyperthermia uses radio frequency waves to heat deeper tissues or limbs. Typically the area to be heated is surrounded by ring of radiating elements. Whole body hyperthermia requires the use of warm water blankets, inductive coils or thermal chambers. This method delivers the thermal energy to the entire body and is frequently used with other systemic therapies e.g. chemotherapy.
It seem as though researchers have completely forgotten the fact the Coley treated his patients with a simple mixed bacterial vaccine. I think that these two groups of researchers should take some time out and review Dr. Coley's seminal work.
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