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by Nicholas Gonzalez, M.D.
We do not allow refined or junk food, such as white flour, white bread, white rice, white sugar in all its many incarnations, and synthetic or chemicalized food. We always believe the cleaner the food the better, and believe that organic generally is best.
If we move from the general to the specific, in our experience all patients with pancreatic cancer fall into the sympathetic dominant category, and therefore, in our model, require a plant-based diet. Though for our practice we prescribe a variety of “vegetarian” diets depending on the patient’s particular inherent level of sympathetic activity (there is a continuum of both sympathetic and parasympathetic dominance), most pancreatic patients end up on what we call the “Moderate Vegetarian Diet.” This program emphasizes and allows all plant foods, including unlimited vegetables, fruits, nuts, seeds and whole grains. We usually recommend at least a quart of freshly made vegetable juice a day, a good source of concentrated nutrients and enzymes in their raw, undamaged form. This particular diet does include animal protein in limited amounts, specifically eggs and organic whole milk yogurt daily, as well as lean fish such as sole twice a week but no more. We forbid entirely red meat and poultry, which would too strongly stimulate their already hyperactive SNS.
For all our patients, including those on the Moderate Vegetarian
Metabolizer Diet, we always believe the cleaner the food
the better, and believe that organic generally is best. We do not
allow refined or junk food, such as white flour, white bread,
white rice, white sugar in all its many incarnations, and synthetic
or chemicalized food.
In terms of supplements, for those patients diagnosed with
pancreatic cancer we invariably recommend significant amounts
of magnesium, up to 1000 mgs a day,
some potassium, chromium and manganese,
lots of the parasympathetisizing
B’s such as thiamin, riboflavin and
folate—but little of those nutrients
such as calcium, zinc and B12 that
would stimulate their already overactive SNS. We also recommend
large numbers of our pancreatic enzyme product, taken
in divided doses away from meals every few hours.
Case Reports: Six Patients with Pancreatic Cancer
Conventional medical journals often publish case reports, that
is, descriptions of individual patients whose disease might have
taken an unusual course in response to some new treatment.
Such “anecdotal” evidence, as it is technically called, differs
from a controlled clinical trial, in which different treatments are
given to large groups of patients with a particular illness. In
such studies, after a period of time, the researchers then tabulate
and compare the results observed in each group. Some
scientists stubbornly insist that only such rigorous exercises,
pursued under the most stringent rules and regulations, can
“prove” to everyone’s satisfaction that a new treatment for a
disease has any value. They often argue that case reports, these
histories of individual patients, though perhaps interesting or
entertaining, have little scientific merit.
But my mentor Dr. Good, one of the finest scientists of the 20th
century and the most published author in the history of medicine,
always insisted case reports, if properly written and carefully
documented, can teach us much about the potential of a new approach.
In my own situation, when I first began to evaluate Kelley’s
records, Dr. Good said that if I could find even one patient
with appropriately diagnosed, biopsy proven metastatic pancreatic
adenocarcinoma who had lived five years under Kelley’s care
he would be impressed, since no one else in medicine anywhere
to his knowledge had such a case. Dr. Good’s knowledge was
indeed extensive, since he was at the time President of Sloan-
Kettering and an expert in the disease. A single example might
not prove to everyone’s satisfaction that the enzyme therapy had
value, but it certainly should grab the attention of any fair-minded
researcher.
We certainly believe our
individualized dietary and
supplement protocols can
help keep us in excellent
health, and hopefully ward
off killers like cancer and
heart disease.
So case histories do have an important, if not definitive role,
particularly when considering a deadly disease such as pancreatic
cancer for which orthodox medicine can offer little. For example,
in one of the major gemcitabine (Gemzar) studies published in
1997 that led to FDA approval, of 126 patients with inoperable or
metastatic disease, only 18 percent lived one year and none lived
beyond 19 months despite the use of intensive chemotherapy.
With sobering data like this, Dr. Good’s point should be well
taken. Even today, a single patient with appropriately diagnosed
inoperable or metastatic adenocarcinoma of the pancreas who
lives five years, whatever the treatment and whoever did the treating,
represents a rather unusual turn of events.
With these thoughts in mind, I present the following six cases
of patients with biopsy proven, carefully documented pancreatic
cancer. I have included five from our own private practice
experience and one taken from my original Kelley study, all
of whom have enjoyed very prolonged and unheard of survival,
at times—but not always—accompanied by significant disease
regression documented by CT scans or other radiographic studies.
I include the one “Kelley case” for its historical value, and
because this patent’s survival has been so remarkable over a
period of many years. And, though the stories of these wonderful
and courageous patients surviving against terrible odds may
not prove the value of our treatment by the strictest of academic
standards, I believe they rather notably illustrate what enzyme
treatment can do even in the most dire of circumstances.
Before I turn to the cases, I did want to make yet another
point, one that Lyle always brings up whenever we talk. Lyle
sees our therapy not only as a potentially valuable treatment for
serious cancer and other degenerative diseases such as heart
disease (yes, we treat cancers other than pancreatic, and yes,
we treat diseases other than cancer) but as a tool for prevention.
In this I agree with him 100 percent. Though indeed Dr.
Isaacs and I spend much of our lives and very long days treating
cancer of all types with generally gratifying results, we certainly
believe our individualized dietary and supplement protocols
can help keep us in excellent health, and hopefully ward off
killers like cancer and heart disease.
We do have patients in our practice without any major illness,
often the spouses or family members of our cancer survivors,
who begin our regimen strictly to improve their overall health
and help keep future disease at bay. I myself live by my own rules
and have followed an aggressive nutritional program since I first
met Dr. Kelley in 1981, after my second year of medical school.
The rewards have been great. I often tell patients I could not
work long days, seven days a week, caring for hundreds of very
ill patients from all over the world, continuing our research and
writing efforts, fighting the usual political battles, etc. were I not
on my own preventive therapy. Though beating cancer may be
dramatic, the more subtle day in day out, year in year out benefits
of appropriate diet and appropriate supplementation offer enormous
promise for all of us. My experience with many patients
has taught me that superb good health enjoyed over long lives is
not a pipe dream, but a very real and attainable goal.
Finally, in the following discussions, I identify patients by
numbers, to protect their identity. I learned a long time ago as
proud as we are of our successes, their privacy is important.
Patient #1: A 15-Year Survivor
Patient #1, like so many of my patients, has an unusual background,
with a graduate degree, study abroad, and expertise in
art. Before we first met, he had worked successfully in business
for many years. His very devoted wife had a Ph.D. and had, before
retirement, worked as a college professor.
In terms of his medical history, he had been a heavy smoker,
but otherwise seemed to be in good shape when in July of 1991,
at age 70, a routine chest X-ray during a yearly physical showed
a small right lung nodule, suspicious for possible malignancy. A
follow-up CT scan of the chest confirmed a 6 mm nodule (about
a quarter of an inch) in the right upper lung, associated with a
mildly enlarged lymph node. A CT of the abdomen done the same
day revealed four lesions of the right lobe of the liver consistent
with metastatic cancer, a tumor sitting in the right adrenal gland,
enlargement of the left adrenal, and a 4.5 cm mass in the pancreas.
To make matters even worse, a bone scan showed increased
uptake in the right shoulder and right hip that the radiologist
thought consistent with metastatic disease. With these studies,
Patient #1 had been given a death sentence.
Though his doctors were convinced he suffered terrible advanced
cancer, they needed a tissue sample to confirm the diagnosis
and determine the most likely primary site. So, Patient #1
then underwent surgery on his chest to remove the right lung
nodule, which proved to be “moderately differentiated adenocarcinoma,”
a very aggressive type of cancer that can originate
in the lung or pancreas. Though initially his doctors debated
where the cancer originated, the consulting oncologist felt this
was most likely pancreatic cancer that had metastasized to the
lung, and not the other way around. In either case, the prognosis
was abysmal, since neither pancreatic nor lung cancer respond
to standard therapies such as chemotherapy, and in either case
patients face an average survival in the range of several months.
Because of his extensive disease at the time of diagnosis,
his doctors told Patient #1 he had no more than two months
to live, and that neither chemotherapy nor radiation could help.
Instead of giving up and getting his affairs in order as the doctors
suggested, he and his wife decided to take the situation
into their own hands. They both began reading voraciously
about cancer, and nutrition, and alternatives. He began ingesting
large numbers of supplements, including vitamin C, vitamin
E, even pancreatic enzymes after reading an article discussing
our work. He also switched his eating habits to a largely plant
based, raw diet, and began juicing intensively, with his devoted
wife’s help.
I first saw Patient #1 in December 1991, fifteen long years
ago. Despite his dire situation, he wanted to live, trusted me
implicitly, and proved to be a very determined and compliant
patient. He seemed to have absolute faith that he could get
well on my therapy, and the results, though gradual in coming,
were gratifying. Within a year, his general health had improved
substantially, and a CT scan of the abdomen done 18 months after
his initial diagnosis showed virtually no change in any of the
lesions. Technically, the cancer hadn’t improved, but it hadn’t
advanced—and he was still alive.
After that set of scans Patient #1 told me he wanted no more
testing, period. Since he had already long outlived his doctors’
dismal predictions, he figured he didn’t care what the scans
might show and wouldn’t change his treatment anyway. So he
happily continued his therapy, feeling grateful for each and every
day, and went back to living. He resumed giving tours and
lectures at a local art museum and he and his wife enjoyed their
retirement for which they had long planned.
In 1997, after he had followed his nutritional protocol for
over five years, and with some pleading from me—since I am
at heart a scientist and wanted to know what was going on with
him—he agreed to undergo radiographic studies. A CT of the
abdomen from March 1997 showed two mildly enlarged adrenal
glands and a very small, less than 1 cm (less than one half
inch) mass in the dome of the liver. However, the other large
liver lesions were gone. The radiologist in his report described
the pancreas as normal—the previously documented large
tumor had simply disappeared.
Then sixteen months later, in July of 1998, nearly seven years
after his diagnosis, Patient #1 agreed at my urging once again
to “suffer through,” as he said, another series of tests. This
time, the radiologist wrote in his summary, “Reading the report
from the 1993 study it sounded like the patient had obvious
metastatic disease and the largest structure being a large porta
hepatis and peripancreatic mass. No such masses are seen today.
There is no adenopathy. The adrenals are prominent and
there are two very small liver lesions that cannot be characterized
because of their small size.”
Patient #1 did well until he drove his car off the side of a road
in 2004. At 84 years old, he should not have been driving, but
wouldn’t listen to me, or his wife about the issue. unfortunately,
he suffered near fatal injuries and required lengthy rehabilitation,
followed by life in an assisted care facility. His wife, three
years older, no longer able to care for herself at 87 years old,
also entered an assisted care facility, where she and Patient #1
struggled to return to fighting shape. They subsequently moved
around a number of times from rehab center to rehab center,
and I had lost contact with both, despite repeated messages
left, and letters sent. But I recently learned that he is still alive,
now 15 years since his terminal diagnosis.
Though beating cancer
may be dramatic, the more
subtle day in day out,
year in year out benefits of
appropriate diet and
appropriate supplementation
offer enormous promise
for all of us.
Patient #2: A Ten-Year Survivor
In terms of his past medical history, Patient #2 had undergone
surgery for localized colon cancer in 1985, but received no radiation
or chemotherapy for the disease. He thereafter did very
well until he developed a large right neck mass about the size of
a golf ball in October 1996, while vacationing out of the country.
After returning to his home city in the Midwest, he underwent
a biopsy in December 1996, which revealed “adenocarcinoma”
his doctors assumed had metastasized from some abdominal
organ, though they weren’t initially certain of the point of origin.
The pathology slides were then sent to Memorial Sloan-Kettering
for evaluation; there, the tissue was thought consistent with
“metastatic poorly differentiated adenocarcinoma with focal
signet ring cell features to lymph node. Possible primary sites
include lung, stomach and pancreas,” but, interestingly enough
in view of his history, not colon. Patient #2 apparently had developed
a completely new cancer.
Patient #2 then began extensive testing, including CT scans
of the chest and abdomen as well as bronchoscopy to rule out a
lung primary. All of these tests were unrevealing, but a PET scan
at Memorial in January 1997 did show activity not only in the
neck, but in the pancreas as well—indicating that organ as the
origin of the disease.
The Memorial doctors decided on a conservative approach,
suggesting that therapy not be immediately instituted. However,
Patient #2 had learned of our treatment approach, and
decided to proceed with us. I first saw him in our office in January
1997; thereafter, he proved to be a very compliant and determined
patient. A follow-up MRI of the abdomen and pelvis in
October 1997 revealed no evidence of cancer anywhere.
Today, nearly ten years after he started with us, he appears to
be in excellent health, enjoying retirement, and free of his once
life threatening cancer.
We usually recommend at
least a quart of freshly made
vegetable juice a day, a
good source of concentrated
nutrients and enzymes in
their raw, undamaged form.
Patient #3: A Ten-Year Survivor
Patient #3 had been previously very healthy when he first developed
chronic heartburn, gradual weight loss and persistent
diarrhea throughout the summer of 1992. In August of that
year, he became suddenly very weak and short of breath; his
local doctor found him to be anemic, enough so that he had
to be hospitalized for a transfusion. An endoscopy at the time
showed multiple stomach ulcers, which were thought to be the
source of the blood loss. Additional testing revealed elevated
blood levels of the hormone gastrin, which stimulates hydrochloric
acid secretion in the stomach—and which at times can
be secreted in great excess by pancreatic tumors. However, despite
extensive testing, his doctors could find no such lesion in
the pancreas, so after prescribing Prilosec to block acid production,
they sent the patient home.
On the medication he actually did fairly well, with no further
bouts of severe anemia until October 1994, when his gastrin
levels on routine blood testing were again elevated. This time
around, a CT scan did show a 6 to 7 cm mass in the retroperitoneal
area of the abdomen, the region in back of the stomach
where the pancreas sits. After a series of delays, he underwent
exploratory abdominal surgery in March of 1995 at a local hospital;
unfortunately, his surgeon discovered a very large tumor
extending throughout the entire pancreas that because of its
size could not be removed. However, a second smaller tumor at
the base of the liver was excised; this proved to be metastatic islet
cell cancer presumably that had spread from the pancreas.
After recovering from surgery, Patient #3 decided to travel
for a second opinion to the Mayo Clinic, where he was seen in
May of 1995. At Mayo, the original slides were reviewed, and
the diagnosis of islet cell carcinoma confirmed. At the time, the
consulting oncologist recommended no additional therapy, explaining
that it would be best to keep chemotherapy in reserve
for a later date when the cancer had more extensively spread.
I first saw Patient #3 sometime later, in March of 1996. He,
like Patient #1 and Patient #2 proved to be a very determined,
very grateful patient, who followed his nutritional regimen to
the letter.
A little over a year later, in June of 1997, his local doctors sent
him for a follow-up CT scan to check on his progress. This time,
the radiologist reported “no significant change in the appearance
of the patient’s pancreatic mass since previous examinations.”
The tumor was still there, but no bigger.
For several years, since he felt so well, he avoided any testing
until agreeing to another scan in September 2002. The official
report stated “Normal CT scan of the abdomen.” The large tumor
in his pancreas had simply gone away. A more recent scan
was also completely clear, and today, ten years after beginning
his nutritional therapy, Patient #3 continues on his program
and continues doing well, enjoying a full and productive life.
Patient #4: A Six-Year Survivor
In November of 2000, Patient #4 first reported a gradual 25-pound weight loss to her physician. She was quickly referred for
a CT scan of the abdomen, which showed a 3.4 cm mass in the
head of the pancreas. A needle biopsy performed in February of
2001 confirmed a “Poorly differentiated adenocarcinoma, ductal
type,” the most aggressive form of pancreatic cancer. The
slides were also sent to the Mayo Clinic, where the consulting
physicians agreed with the diagnosis.
Since the disease seemed localized to the pancreas, her physicians
thought the tumor might be operable. She was urged
to undergo extensive surgery, but the patient, who had already
learned about our approach, decided the risks were too great,
the potential benefits too meager, to warrant such an operation.
Instead, in March of 2001, she consulted with Dr. Isaacs
in our office. A month after she began her nutrition treatment,
she underwent repeat CT scan testing, which revealed a 3.2 cm
mass in the head of the pancreas, with no evidence of metastatic
disease.
A follow-up CT scan performed in January 2002, some ten
months after she began treatment with Dr. Isaacs, indicated
a 3.0 x 3.0 cm mass in the head of the pancreas, somewhat
smaller than noted in April 2001. The next CT scan in July 2003,
after Patient #4 had followed her nutritional regimen for more
than two years, showed a 3.16 x 2.6 cm mass in the head of the
pancreas, and a CT scan not quite a year later revealed a 3 x 2.8
cm mass.
Patient #4, now a five and a half year survivor, is generally in
excellent health, enjoying her life. In her case, the CT scans show
perhaps some slight shrinkage in her tumor, but no spread.
Given the aggressive nature of pancreatic adenocarcinoma, its
tendency to metastasize and kill quickly, her course has truly
been remarkable. We do find in our practice that though tumors
can at times disappear, at times in some patients they seem to
stabilize, for years at a time.
Patient #5: A Five and a Half-Year Survivor
Patient #5, with a long history of GERD (gastroesophageal reflux
disease) decided in January of 2001 to undergo laparoscopic
surgery for correction of what was presumed to be a simple
hiatal hernia. However, during the procedure, his doctor, as the
records state, discovered “multiple umbilicated, white, firm,
and gritty tumors in both the right and left lobes of the liver,
apparently occupying approximately 50 percent of the volume
of the liver.” This, to say the least, is a lot of cancer.
A biopsy of one of the liver lesions confirmed “poorly differentiated
metastatic carcinoma,” with, as the pathology report
describes, some “neuroendocrine differentiation.” After
surgery, a CT of the chest, abdomen, and pelvis revealed a large
6.5 x 3.7 cm mass in the tail of the pancreas, with diffuse hepatic
metastases.
The patient subsequently met with an oncologist at a major
Midwest academic center, who suggested aggressive chemotherapy
with cisplatin and etoposide for 4 cycles. The oncologist
admitted that even with chemotherapy, the disease would
ultimately progress and prove deadly. Before agreeing to the
treatment, in February of 2001 the patient traveled to Memorial
Sloan-Kettering in New York for a second opinion. The doctors
at Memorial reviewed the slides, confirmed a very aggressive
pancreatic carcinoma and proposed the same chemotherapy
protocol that had been previously recommended. The oncologist
at Memorial said that unfortunately, even with aggressive
treatment, Patient #5 might live at most two years. Chemotherapy,
as he had been told before, might shrink his tumors and
prolong his life, but would not be a long-term solution.
At that point, he was not yet aware of our approach, so with
no apparent options, he agreed to begin a four-cycle course of
chemotherapy in February 2001 administered by his local doctors
in the Midwest. After his second cycle of chemotherapy,
a CT scan in March 2001 did show response, with marked improvement
in the numerous liver metastases and shrinkage in
the pancreatic tail mass.
Patient #5 completed the first 3 cycles without much difficulty, but during the 4th cycle he became so ill the regimen had
to be discontinued in April of 2001. At that time, after learning
about our work, he decided to proceed with our treatment. I
first saw him in my office in May 2001, a month after chemotherapy
had been halted. He had no scans at that point, but a CT
of the abdomen done October 2001, five months after he began
his nutritional protocol, revealed a normal appearing pancreas
with a single lesion in the liver. By that point, Patient #5, who
proved very determined and very compliant, seemed to be improving
in terms of his general health.
A CT of the abdomen in February 2002, 10 months after he
had first come to our office, indicated multiple small lesions in
the liver. I made several adjustments in his regimen, and repeat
CT scans in October 2002 confirmed that all the liver tumors
were gone. Follow up scans in March 2003 and June 2004 were
also completely clear. He has now been following his nutritional
regimen for five and a half years, is approaching six years from
his original diagnosis of very advanced and very terminal pancreatic
adenocarcinoma, and appears disease free.
We also recommend large numbers of our pancreatic enzyme product, taken in divided doses away from meals every few hours.
Patient #6: A Twenty-Four-Year Kelley Survivor
I first learned of Patient #6 while reviewing the records of patients
with pancreatic cancer treated by Dr. Kelley. I thought I
would include her to illustrate the kind of successes uncovered in
Dr. Kelley’s files, as I pursued my five-year study of his therapy.
In early 1980, Patient #6 first experienced occasional bouts
of mid-abdominal pain that gradually worsened over a two-year
period. Despite the symptoms, Patient #6 did not seek medical
assistance until August 1982, when she was admitted to the local
emergency room of her Midwest town with excruciating pain.
When an ultrasound showed only gallstones, her doctors assumed
she might be suffering from gallbladder disease, and
proposed cholecystectomy.
Within days, she underwent exploratory surgery and removal of
the gallbladder. However, the surgeon also discovered a pancreatic
mass that had invaded into the surrounding tissues, as well as a
single 1 cm tumor in the liver, which he biopsied. Due to the extent
of disease, he made no attempt to excise the pancreatic tumor.
The liver specimen proved consistent with adenocarcinoma
that had spread from a pancreatic primary. After recovering from
surgery, Patient #6 met with an oncologist, who told her that
although chemotherapy might prolong her life slightly, no treatment
could cure her disease. He suggested she get her “affairs in
order.” In the official records, this physician wrote: “The patient’s
prognosis is judged to be between 9 and 15 months at most.”
After recovering from surgery, Patient #6 decided to seek out
a second opinion at the Mayo Clinic in Rochester, Minnesota.
When seen at Mayo in mid September, a CT scan revealed an
enlarged pancreas, and blood studies indicate abnormal liver
function tests. At the conclusion of his evaluation, the consulting
oncologist wrote, in the official discharge summary:
“I had a long discussion with her regarding treatment for
her cancer. At the present time I would favor simply observation
since we know of no known treatment that will necessarily
prolong her life. Since she is feeling well at the present time I
did not feel justified in making her symptomatic from the side
effects of chemotherapy.”
Fortunately, Patient #6 learned of Dr. Kelley’s work from a local
health food store owner, and shortly thereafter began treatment
with him in December of 1982. She responded quickly,
and within six months was back to working long days in the
family business.
By the time I completed my Kelley study in 1987, Dr. Kelley
had closed down his office and disappeared. After I started my
own practice, I lost touch with Patient #6 until she referred a
patient to me in the mid 1990s. At that time she was in excellent
health twenty years out from diagnosis, still following her
prescribed diet and still taking pancreatic enzymes. I heard recently
that she is still alive, still active, and still enjoying her life,
now 24 years from her original Mayo confirmed diagnosis of
metastatic adenocarcinoma of the liver.
To read Part I click here
For more information visit Nicolas Gonzalez, M.D.
and Linda Issacs, M.D. 0n the web at www.dr-gonzalez.com.
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