Killing Us Softly

by Dr Paul Offit

  If the IDSA guidelines held, insurance companies might stop paying for expensive therapies; nothing threatened Lyme Literate doctors more than that.

  By May 2008 the IDSA had already spent $250,000 fending off Blumenthal’s lawsuit. The IDSA was an organization of nine thousand members with meager dues—it didn’t have much money. “One of the things that really worried us was that we were not a financially large organization compared to the Office of the Attorney General of the State of Connecticut,” recalled Anne Gershon, president of IDSA at the time. “We were really worried that they would be able to break us financially.” So both sides came to an agreement. The IDSA would form another committee. This time, however, Howard Brody, an ethicist from the University of Texas in Galveston, would determine who had unacceptable conflicts of interest.

  On April 22, 2010, the new IDSA committee issued its final report. The panel had carefully reviewed the guidelines for more than a year, conducted a public hearing, taken evidence from more than 150 people, and issued a sixty-six-page document that contained 1,025 references. It is hard to imagine how they could have been more thorough. The results were the same. The new panel agreed with the previous panel that Chronic Lyme didn’t exist, concluding, “the recommendations contained in the 2006 guidelines were medically and scientifically justified on the basis of all of the available evidence and no changes to the guidelines are necessary.” Blumenthal had insisted that at least 75 percent of new panel members support the 2006 guidelines or they would be revised. In fact, 100 percent supported them. Lyme Literate doctors were outraged. They argued that Brody, by restricting panel members to those who had made less than $10,000 a year caring for Lyme patients, had excluded several panelists who believed in Chronic Lyme (and had made far more than that).

  Chronic Lyme advocates had had their day in court, several testifying in front of the new panel. “It was a very collegial meeting,” recalled Carol Baker, professor of pediatrics at Baylor College of Medicine and head of the new panel. “We were more credible and open-minded than they had expected. We talked to them at the breaks. We cared.” Lyme organizations were so convinced that the guidelines would be revised in their favor that they celebrated in the same hotel where the panelists stayed. “I think they were expecting a different outcome,” recalled Baker. When the panel upheld the previous recommendations, the Chronic Lyme community targeted Baker. “I got Internet threats that said, ‘You have no compassion for patients,’ ‘You don’t care about people.’ The e-mails went on for a year. It wasn’t fun.”

  After the second panel agreed with the first, Blumenthal said his office was “reviewing the IDSA’s reassessment of its 2006 Lyme disease guidelines to determine whether [it had] fulfilled requirements of the settlement.” And that was it. No apology. Nothing. “I never heard another word from him,” recalled Baker. Certainly Blumenthal owed an apology—an apology to the little girls who had had their gallbladders removed, or the woman who had died from long-term antibiotic therapy, or the man who had died from bismuth therapy, or the two New Jersey residents who had suffered from malaria therapy, or the woman who had cashed in her retirement account to pay the $15,000 monthly fees required by Lyme Literate doctors to treat a disease that doesn’t exist. A disease that Blumenthal had done everything he could to promote to the press and the public.

  Richard Blumenthal had tried to make Chronic Lyme a story about people, not science. Although he might have eventually stacked the committee with enough fringe doctors to change the IDSA guidelines, he wouldn’t have changed the science of Lyme disease any more than Dan Burton would have changed the facts about laetrile or Taylor Record the value of pi. In their critique of the Blumenthal affair, Gostin and Kraemer summed it up best. “The scientific process is not democratic,” they wrote. Science isn’t about who gets the most votes; it’s about the quality, strength, and reproducibility of the evidence.

  On January 5, 2011, Richard Blumenthal was sworn into the United States Senate, taking the seat vacated by Christopher Dodd. He was immediately appointed to the Health, Education, Labor and Pensions committee.

  Part V

  THE HOPE BUSINESS

  8

  Curing Cancer: Steve Jobs, Shark Cartilage, Coffee Enemas, and More

  Of all the ghouls who feed on the bodies of the dead and dying, the cancer quacks are the most vicious and heartless.

  —Morris Fishbein, former editor of the Journal of the American Medical Association

  In October 2003, Steve Jobs, cofounder of Apple Computer, was diagnosed with pancreatic cancer. A brilliant, restless innovator, he designed mp3 players, smartphones, and the first successful line of personal computers. Jobs liked being in charge, liked making decisions. Faced with cancer, he took control. Most pancreatic tumors are untreatable (so-called adenocarcinomas), but Jobs had a neuroendocrine tumor—with early surgery, he had an excellent chance of survival. Unfortunately, for nine months, Jobs, a Buddhist and vegetarian, treated himself with acupuncture, herbal remedies, bowel cleansings, and a special cancer diet consisting of carrot and fruit juices. His choice proved fatal. By the time he had surgery, the cancer had spread. On October 5, 2011, after spending years in and out of the hospital, Steve Jobs died of a treatable disease.

  Jobs wasn’t the first to be seduced by bogus cancer cures.

  In the 1800s, medicine men sold wondrous elixirs that—once analyzed—weren’t so wondrous. Benjamin Bye’s Soothing Balmy Oil cancer cure contained cottonseed oil, almond oil, sarsaparilla, talcum, and Vaseline. Chamlee’s Cancer Cure—made from “an exotic Pacific Island shrub”—contained alcohol, iron, saccharine, and strychnine; and Curry’s Cancer Cure contained hydrogen peroxide, iodine, laxatives, and cocaine. The Radio-Sulpho Cancer Cure had Epsom salts in a cast of Limburger cheese, netting $1 million for its inventor. The Toxo-Absorbent Cure contained sand and clay (to draw the cancer out). And Dr. Rupert Wells sold Radol, advertised as “radium-impregnated fluid,” though it didn’t contain any radium. Even John D. Rockefeller’s father got in on the act, selling his bogus cancer cures at county fairs with the help of magicians, hypnotists, and ventriloquists.

  Early American cancer cures were accompanied by heart-rending testimonials, were a gold mine for their promoters—and were utterly worthless.

  In the early twentieth century, Albert Abrams married America’s fear of cancer to its love of gadgetry.

  Abrams was born in San Francisco in 1864. After attending the University of Heidelberg, in Germany, he returned to California to become a respected neurologist, professor of pathology, and vice president of the California State Medical Society. Then, in 1910, Albert Abrams became “the dean of twentieth-century charlatans.”

  Abrams claimed that cancers—as well as diseases like tuberculosis, gonorrhea, and syphilis—emitted different vibrations, like radio waves. To detect them, he invented the Dynamizer, a boxed jungle of coils, batteries, and rheostats. Two wires came out of the box: one plugged into a wall socket, and the other cupped onto the patients’ forehead. To make the correct diagnosis, Abrams took a drop of the patients’ blood and placed it inside the box. Patients then stripped to the waist, faced west, and stood in a dimly lit room while Abrams felt their abdomen. The Dynamizer could also detect the patients’ place of birth, ethnic background, year of death, religion (Jews had duller abdomens than Christians), and golf handicap. Abrams leased his machine for $250 (the equivalent of about $8,000 today), with a $5 monthly user fee. Robert Millikan, winner of the Nobel Prize in Physics in 1923, described the Dynamizer as something “a ten-year-old boy would build to fool an eight-year-old.”

  Abrams soon realized that diagnoses alone weren’t enough, so he invented the Oscilloclast, which sent out specific vibrations to counter disease. No one was more impressed than Upton Sinclair, the Pulitzer Prize–winning author of The Jungle. In an article titled “The House of Wonders,” Sinclair praised Abrams’s breakthrough technology, an endorsement that sent sales through the roof. By the early 1920s, thou
sands of doctors, mostly chiropractors, were using Abrams’s machines. Like many scientists, however, the senior editor of Scientific American didn’t buy Sinclair’s endorsement, arguing that his name “meant no more in medical research than Jack Dempsey’s would mean in a thesis dealing with the fourth dimension or Babe Ruth’s on the mathematical theory of invariance.”

  Eventually, scientists put Abrams’s Dynamizer to the test, sending him blood from animals and dead people. Abrams—assuming that he was evaluating living men and women—diagnosed a guinea pig with cancer, a sheep with syphilis, a rooster with sinusitis, and a dead man with colitis. The public never caught on to the fraud. When Abrams died in 1924, he had amassed a fortune of more than $2 million.

  In the 1940s, William Koch invented a bogus cancer cure called glyoxylide, a combination of two carbon monoxide molecules. Unfortunately, carbon monoxide molecules don’t stay together very long—separating in less than a hundred-millionth of a second into a gas. Koch sold his cure to thousands of doctors, who charged $300 per injection. When analyzed, chemists found that Koch’s glyoxylide contained water—and water only.

  In the 1950s, several years after researchers at Boston Children’s Hospital had proved that chemotherapies like aminopterin could treat certain cancers, Harry Hoxsey invented yellow, pink, and black medicines. Yellow medicine was a paste made of arsenic to treat skin cancer. Pink and black medicines treated “internal” cancers. Pink medicine contained pepsin (a meat tenderizer) and potassium iodide (a chemical used to iodize table salt). Black medicine contained prickly ash bark, buckthorn bark, barberry root, licorice root, pokeweed, alfalfa, and red clover blossoms (together, a botanical laxative).

  Among the twentieth century’s greatest cancer frauds, no one was more successful than Hoxsey. After he had dropped out of school in the eighth grade, he supported himself as a coal miner, insurance salesman, and boxer. But it was an old family remedy that changed his life. Hoxsey’s great-grandfather, a Kentucky farmer, claimed to have cured a horse of bone cancer with mashed flowers, ground stalks, and boiled roots. Harry’s father inherited the formula and passed it on; black medicine was born.

  Hoxsey moved around, selling his cancer cures in Iowa, Michigan, West Virginia, and New Jersey, often getting convicted of practicing medicine without a license. Eventually, he moved to Dallas and got a license as a naturopath, effectively keeping the police at bay. Within a few years, Hoxsey owned clinics in Denver, Los Angeles, and fifteen other cities. By the early 1950s—with ten thousand patients on the books—Hoxsey was earning $1.5 million a year. On his desk he had a sign that read, “The world is made up of two kinds of people—’dem that takes and ’dem that gets took.” Hoxsey took, buying oil wells, real estate, automobiles, an airplane, and a six-hundred-acre ranch. “The man upstairs is smiling favorably on me,” he said. “I’m a friend of Mr. H. L. Hunt, the wealthiest man in the nation, and he’d better look out, I’m catching up with him.”

  By the mid-1950s Harry Hoxsey’s clinic in Texas was the largest private cancer clinic in the United States. Then Hoxsey confused commercial success with clinical success. Anxious to be taken seriously, he sent records of his most dramatic cures to scientists at the National Cancer Institute, who found that Hoxsey’s patients had either never had cancer, still had cancer, were cured before they came to his office, or were dead.

  Hoxsey’s career ended precipitously when the parents of a sixteen-year-old boy with bone cancer chose pink and black medicines instead of a lifesaving amputation. After the family successfully sued him for fraud, Hoxsey fled to Tijuana and set up another clinic. In 1974, Harry Hoxsey died of prostate cancer complicated by a heart condition.

  In the 1960s, Andrew Ivy promoted the next great cancer cure: Krebiozen. Ivy’s rise was matched only by his fall.

  Andrew Ivy was born in Farmington, Missouri, in 1893. He attended the University of Chicago and Rush Medical College, where he received his bachelor of science in 1916, master of science in 1917, PhD in 1918, and MD in 1922. During the next thirty-five years, Ivy published fifteen hundred papers in the fields of gastroenterology, aviation medicine, reproductive medicine, blood clotting, artificial respiration, cardiac pain, flash burns, and typhoid infections. By 1970 Ivy’s work was cited more than that of any other scientist in the world. His textbook, Peptic Ulcer, written in 1950, is still a classic.

  In recognition of his achievements, Ivy was made head of physiology and pharmacology at Northwestern University Medical School and vice president of the University of Illinois. But to most Americans, Andrew Ivy was the man who helped prosecute Nazi doctors accused of torture and murder—and the author of “The Nuremberg Code,” a manifesto on the ethics of human experimentation. (For his efforts, Ivy was awarded the Certificate of Merit from the president of the United States.) Jonathan Moreno, in his book Undue Risk: Secret State Experiments on Humans, wrote “by the end of the war [Ivy] was probably the most famous doctor in the country.”

  Then, in July 1949, after a visit from Stevan Durovic, Andrew Ivy began his uninterrupted fall from grace. Durovic, who had fled his native Yugoslavia for Argentina, believed he had a cure for cancer. While in Argentina, Durovic injected horses with a bacterium called Actinomyces bovis, collected their serum, freeze-dried it, and resuspended it in mineral oil. He called his new medicine Krebiozen. When Durovic came to the United States, he knew that Andrew Ivy was the man to see. For years, Ivy had studied dogs with cancer of the thyroid, believing they produced a natural anti-cancer substance; but he couldn’t find it. Durovic, on the other hand, believed he had.

  Before coming to Ivy, Durovic had tested Krebiozen on twelve dogs and cats with cancer, claiming that all had improved or been cured. Ivy was impressed, so he injected himself, a colleague, and one dog with the drug. Convinced of its safety, Ivy injected the first cancer patient on August 20, 1949. On March 27, 1951, after treating twenty-two patients, he announced his findings at a press conference at the Drake Hotel, in Chicago, inviting local doctors, potential financial supporters, the mayor of Chicago, two United States senators, and science writers from four Chicago newspapers. Ivy claimed that all his patients had experienced “dramatic improvement.” In truth, ten of the twenty-two were dead—all from cancer.

  Ivy’s international reputation spurred interest in Krebiozen. Within a few years more than four thousand cancer sufferers had been treated. In 1952, cancer specialists reviewed patient records and concluded that Krebiozen was worthless. In 1961, the National Cancer Institute, after conducting its own study, reached the same conclusion. When FDA chemists finally analyzed Krebiozen, they found it contained mineral oil and creatine, a harmless substance found in muscles. Krebiozen was a hoax.

  In 1964, Andrew Ivy and Stevan Durovic were indicted on forty-nine counts of mail fraud, mislabeling, conspiracy, and making false statements. After he was acquitted, Durovic moved to Switzerland, where he had deposited $2 million in a Swiss bank account. Ivy, shunned by his colleagues, died in 1978, still convinced that Krebiozen was a cure for cancer.

  By the 1980s, Max Gerson invented a miracle cancer diet.

  Gerson was a German-born physician who immigrated to the United States in 1936. Taking advantage of American’s fear of environmental toxins, he offered a two-step cure: eat natural foods, consisting of a gallon of blended fruits, vegetables, and raw calf’s liver, and remove harmful toxins with daily coffee enemas. Gerson’s therapies also included liver extract injections, ozone enemas, “live cell therapy,” thyroid tablets, royal jelly capsules, linseed oil, castor-oil enemas, clay packs, massive doses of vitamin C, and a vaccine made from killed staph bacteria. In the mid-1980s, three naturopaths—wanting to believe Gerson was onto something—visited his clinic, in Tijuana, and followed eighteen patients for five years; seventeen died of their cancers, and one still suffered the disease. The National Cancer Institute also reviewed the records of eighty-six patients treated with the Gerson diet and found no evidence that it worked—a finding that apparently didn’t impr
ess Steve Jobs when he chose Gerson’s therapies instead of the surgery that might have saved his life.

  The Gerson diet had other problems. Between 1980 and 1986, thirteen patients were admitted to local hospitals suffering from bloodstream infections caused by Gerson’s liver extract injections. The Gerson Institute is still in operation.

  In the 1990s, it was shark cartilage.

  On February 28, 1993, CBS’s 60 Minutes aired a story claiming that shark cartilage cured cancer. The segment starred I. William Lane, a Florida businessman who owned a shark-fishing company. Lane had written a book titled Sharks Don’t Get Cancer. During the program, correspondent Mike Wallace showed several Cuban cancer victims exercising, all claiming that shark cartilage had cured them. Wallace was impressed, gushing about the new drug, cleverly called BeneFin.

  Within two weeks of the 60 Minutes episode, thirty new shark cartilage products were on the market. Within two years, shark cartilage was a $30-million-a-year industry. In 1996, Lane wrote Sharks Still Don’t Get Cancer. By the late 1990s, one in four cancer sufferers took shark cartilage.

  In preparing his program, Mike Wallace had either ignored or was unaware of several facts. First, according to the Smithsonian Institution’s Registry of Tumors in Lower Animals, sharks do get cancer, including cancer of the cartilage. Second, before the show, Lane had already enlisted a group of Belgian researchers to test his product. It didn’t work. Third, even if shark cartilage did cure certain cancers, eating it didn’t make much sense. Acids and enzymes in the stomach destroy proteins contained in cartilage. (That’s why diabetics don’t eat insulin; they inject it.) Within a few years of the 60 Minutes episode, thirteen studies showed that shark cartilage didn’t cure cancers of the breast, colon, lung, or prostate. In 2000, I. William Lane and his company were banned from making unsubstantiated claims that shark cartilage cures cancer.