Like yesterday’s post, this will be a post that references our favorite dubious cancer doctor Stanislaw Burzynski but is not primarily about him. However, given the nature of the subject matter, it is impossible not to think of Burzynski, as comparisons are inevitable. Whereas yesterday all we were dealing with was a rather amusing “award” that Stanislaw Burzynski was awarded by a quack who had somehow conned a prominent Cardinal to give the Church’s imprimatur on a Catholic medical order he wanted to resurrect to get other quacks to join, this week we’re dealing with a serious subject: Cancer cure testimonials. This particular cancer cure testimonial brings Burzynski to mind for the simple reason that it is virtually identical to a typical Burzynski cancer cure testimonial for a brain cancer patient except that the therapy used was not antineoplastons. It has all the same elements: a child with a brain cancer who underwent conventional therapy with surgery, radiation, and chemotherapy but recurred; parents deciding to choose an “alternative therapy”; and finally a seemingly miraculous “cure.” Regular readers of this blog who have seen my posts on Stanislaw Burzynski should be well familiar with the general outlines of such testimonials, but this one is not from a Burzynski patient.
I learned about this young patient from a quack about whom I’ve written several times over the years. I’m referring, of course, to Robert O. Young, for which every disease (excuse me, “dis-ease”) is due to too much acid and the cure is “alkalinization,” which is accomplished, or so Young claims, through an “alkaline” diet and lifestyle. Young is a remarkable variety of quack in that to him cancer isn’t the problem; to him it’s nothing more than a “poisonous acidic liquid” in which normal cells “spoiled by acid,” and the tumor is the body’s protective reaction to these cells. He also believes that bacteria don’t cause sepsis (acid does), that viruses are in reality “molecular acids,” and that there is no such thing as good bacteria. (Yes, basically at heart Robert O. Young is a germ theory denialist.) The amusing thing, not to mention evidence of Young’s utter lack of understanding of basic human physiology, is that many of the foods Young recommends to “alkalinize” the body are, in fact fairly acidic, particularly citrus fruits. Young, as you might recall, is the quack responsible for treating Kim Tinkham, the woman with breast cancer who appeared on The Oprah Winfrey Show several years ago and announced that she would not use conventional therapy to treat her cancer but would instead rely on The Secret and Robert O. Young. The result was that she died of her disease two and a half years ago.
This time around, the quack is not Robert O. Young, but rather a naturopath named Bernardo Majalca who treated Josie using the same sort of brain dead ideas about human physiology that Young believes, which is probably why Young trumpets her story so proudly:
After having surgery, chemotherapy and radiation, eight year old Josie Nunez’s brain tumor reappeared for a second time and doctors gave her only weeks to live. Her parents searched the internet for anything that could help their daughter and found Dr Bernardo Majalca, a naturopath, who offered them hope as well as a natural cure for Josie.
Dr Majalca said that Josie wasn’t dying of cancer but was dying from acidosis, and that only by addressing this issue would her body finally be able to heal. He prescribed an alkalizing diet which included drinking 4 freshly made juices per day, as well as various herbs to help detoxify and rebuild her immune system. He describes more about his treatment plans in the video links below.
Substitute the word “antineoplastons” for “alkaline diet” and the name Bernardo Majalca for Stanislaw Burzynski, and the above testimonial would be indistinguishable from many other Burzynski testimonials. This lets me bring up a point. Majalca’s and Young’s “alkalinization” are far more obviously quackery than Burzynski’s antineoplastons. As I’ve already conceded many times, it is (or at least was) possible that antineoplastons had significant antitumor activity. I say “was” possible because I think that the evidence over the last several years has pretty conclusively shown that, if antineoplastons do have any anticancer activity at all (which is doubtful), it’s minimal. Certainly it’s not the magnitude of anticancer activity that would lead Burzynski’s treatments to be so incredibly better than conventional treatments for inoperable brain tumors, for example. As far as all the available evidence appears to indicate, they are not. However, regardless of what Burzynski did with antineoplastons, they are chemotherapy. Compared to the utter nonsense and twisting of our understanding of physiology at the heart of the “alkaline lifestyle” as a cure for cancer. If you don’t believe that it’s utter nonsense, just try watching these two videos by Bernardo Majalca:
Yes, he is telling patients that cancer is “no big deal” and that they’re “not going to die from it.” He even says that most women get breast cancer because they’re angry at men. I kid you not. In fact, he even claims it’s the job of cancer to fertilize the egg and create the embryo. Again, I kid you not. As is so frequently the case among quacks, he copiously abuses poor Otto Warburg and says that it’s not the cancer that kills patients but the treatments. To “Dr. Bernardo,” angry, strong emotions cause acidosis, which causes cancer. My favorite quack claim is that when the body pH is 4.5 you die. Here’s a hint for Dr. Bernardo. If your body pH (as in your plasma pH) is less than around 7.0, you’re almost certainly dead. I don’t recall seeing a patient with a pH below 7.0 who ultimately survived. In fact, as I described in great detail before, the body maintains its pH within a very tight range, usually between 7.35 and 7.45.
Of course, what Dr. Bernardo is referring to is not really the pH within the body. Like most acid-base quacks, Robert O. Young included, all he’s referring to is pH of saliva or urine, which is how these quacks measure pH, thinking that these pH measurements are actually reflective of the acid-base status of the body.
If you’re not convinced yet about Dr. Bernardo, more quackery follows:
So the claim is that Josie’s two remaining tumors in her brain shrank so small that it took 3 MRI sessions at different positions to detect them and that not long after that they were undetectable.
In other words, comparing the results of this particular testimonial with the results of Burzynski’s testimonials should tell you something, and that something is very instructive. Basically, the story of Josie Nunez tells us that it is quite possible for a useless therapy to appear effective from time to time even in a very bad brain tumor. Like many of Burzynski’s patients, Josie had the full Monty, everything conventional therapy could throw at her tumor: surgical resection, radiation therapy, and chemotherapy. One thing we don’t know is what kind of tumor she had. Nowhere have I been able to find a description of her tumor histology. Was it a glioblastoma (the most common childhood brain tumor)? Who knows? Be that as it may, compared to antineoplastons, the “alkaline lifestyle” used to treat Josie was almost certainly much, much less likely to have an effect on the brain tumor being treated. That Josie apparently did well while undergoing an ineffective treatment has implications for analyzing Burzynski’s testimonials. Meanwhile, her parents held fundraisers, much like Burzynski patients do, and raised $130,000, $50,000 of which came from her school and $80,000 from a polo tournament fundraiser in which which Tommy Lee Jones and John Walsh played.
So what did happen? Note the description of events. Josie underwent surgery, followed by chemotherapy and radiation, after which the tumor appeared to be gone, Then an abnormality, apparently in the tumor bed, showed up on followup MRI, leading the doctors to think that Josie’s tumor had recurred. There is, however, a phenomenon known as pseudoprogression that can confound treatment decisions regarding second line therapy after an apparent tumor recurrence. Pseudoprogression is a phenomenon in which late effects of radiation therapy can produce enhancing lesions that look all the world on MRI like tumor recurrence. There was a nice review of this topic a few years ago that describes the phenomenon thusly:
Now that concurrent TMZ and radiotherapy are used as standard therapy, the postradiotherapy radiological assessment is made earlier than before, when radiotherapy was given alone. However, it can be difficult to interpret the radiological image obtained, as any changes observed may be due to treatment-related pseudoprogression rather than true disease progression. In their recent study of 51 patients treated with radiotherapy and concomitant TMZ, Chamberlain et al.20 reported seven (14%) cases of early necrosis without signs of tumor recurrence; 26 patients had a radiological diagnosis of early disease progression and, of these, 15 underwent re-resection, with 7 (47%) of the 15 having a surgical diagnosis of radionecrosis. These data open a dual scenario: the possibility of a higher incidence of early radionecrosis and the risk of mistaking the latter for disease progression. In a series of 32 glioma patients, de Wit et al.21 observed that the first postradiotherapy MRI showed progressive enhancement in nine cases; in three of these nine cases, MR images showed improvement or stabilization for 6 months without additional treatment being given.
In patients under treatment for brain tumors, worsening of the preexisting neurological focal deficits, suggesting tumor progression or recurrence, can be accompanied by a neuroradiological image of edema and contrast-enhancing lesion within the tumor bed. However, this radiological pattern is not necessarily associated with any clinical deterioration. These alterations, described in 1979 by Hoffman et al.3 in a group of patients treated with radiotherapy and carmustine (BCNU) at an interval of 8 weeks, were investigated with serial CT or MRI scans. Within 18 weeks following radiotherapy, 49% of patients had a deterioration that strongly suggested tumor progression. In 28% of the cases, however, spontaneous improvement occurred without a change in therapy. Following this pattern, which is indistinguishable from that of tumor recurrence, improvement usually occurs within a few weeks or months, with a thorough neuroradiological follow-up showing that these signs regress within 4–8 weeks. The timing of these clinical features, known as “early delayed reactions” following radiotherapy,4 seems to correspond to the turnover time of myelin.
In other words, in a small but not inconsequential number of cases (perhaps as much as 28%), apparent tumor progression really isn’t. It’s pseudoprogression, delayed but still early effects of radiation therapy mimicking tumor recurrence. The same phenomenon is very likely true for many Burzynski patients who are presented as “success stories.” After all, if we can see cases like Josie from such obvious quackery as the “alkaline life style,” there’s no reason that the same sort of phenomenon couldn’t be the primary cause of some of Burzynski’s apparently amazing results. That’s why in Burzynski’s case clinical trials are absolutely essential. If there’s a real antitumor effect from antineoplastons on brain tumors like glioblastoma above and beyond confounders like pseudoprogression, Of course, the number of patients exhibiting pseudoprogression who don’t ultimately develop a real recurrence that kills them is much, much smaller, but not so small that it can’t explain many of Burzynski’s testimonials. Moreover, it’s important to remember that dead patients don’t give testimonials; so patients of Burzynski’s who don’t do well won’t be around to support The Burzynski Patient Group.
Finally, as is the case with so many testimonials, there’s something fishy here. If you go to the Nunez family website, you’ll see that it hasn’t been updated since 2009, and I have a hard time finding any reference to her after 2009; for instance, this story about her going back to her school after treatment, although there is an episode of a television show called The Incurables in which her episode apparently aired almost a year and a half ago. Either way, it’s not entirely clear how Josie is doing now, which is another typical finding with these testimonials.
In the end, though, whenever Burzynski promoters claim that it’s “impossible” that it couldn’t be the antineoplastons that are responsible for how well certain Burzynski patients with brain cancer are doing. I’d use Josie Nunez as a counterpoint to suggest that it’s quite possible that antineoplastons had nothing to do with their survival, just as it’s almost certain that the “alkaline lifestyle” had nothing to do with Josie Nunez’s good fortune. As is the case with Burzynski patients, it was almost certainly the conventional treatment, not the antineoplastons, that resulted remission. Sometimes, when Burzynski does his incompetent “personalized gene-targeted cancer therapy” for dummies, he might stumble on an effective combination by accident in an individual patient the way the proverbial blind squirrel occasionally finds the nut, but, either way, it’s not Burzynski’s “genius” that’s responsible for such successes, any more than it’s Dr. Bernardo’s genius that was responsible for Josie’s survival. I’m very happy that Josie survived and hope she’s still alive and doing well, but her story is not in any way strong evidence that the “alkaline lifestyle” quackery so beloved of Robert O. Young and practiced by Dr. Bernardo saved her life.