The Promethazine or Phenergan® cancer treatment represents a new way of dealing with cancer by disrupting cancer cell metabolism.
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EXAMINATION OF MUMMIFIED BODIES has established that forms of cancer were known to the ancient Egyptians. Considering the problem from a logistical standpoint, it appears odd that no generally effective treatment has been found when temporary regression of malignant disease is a phenomenon which, though rare, is by no means unknown.
Cancer chemotherapy began in the wake of World War II, when American doctors obtained limited success in treating patients with derivatives of highly toxic mustard gas. Since those early days a huge variety of chemical means of inducing the death of cancers in the living body have been devised.
Conventional chemotherapy has for the most part sought to prevent the growth of cancers by using poisons to block the division of cancer cells. Unfortunately maintenance of the mammalian body involves cellular division within all organs, especially the bone marrow and mucosal surfaces of the intestine. The poisons act indiscriminately against normal and cancerous tissues alike, and are responsible for the unpleasant side effects commonly experienced by so many patients. Nature has shown her resentment of the imposition of unnatural forms of cell death by stubbornly refusing to cooperate with clinicians. The underlying strategy is fundamentally flawed, which is why the current impasse prevails.
The basic difficulty has stemmed from ignorance of how tumour cells die. In fact the seeds of understanding were sown centuries ago. Long before the role of bacteria in infection was understood, it had been known that cancers in hosts developing certain kinds of infection, notably erysipelas, underwent regression, usually temporary. In 1891 the American surgeon William Coley recognised the importance of the observations. "Nature often gives us hints to her profoundest secrets," he wrote, "and it is possible she has given us a hint which, if we will but follow, may lead us to the solution of this difficult problem." He treated patients with a mixture of preparations of pathogenic and non-pathogenic bacteria. Unfortunately the responses were highly variable and much too unsuccessful to use clinically. Therapy with mixed toxins remains the province of the truly heroic, determined to hang on to life come what may.
It was not until the 1970s that the destructive changes underlying the few successes Coley reported were at last understood. When tumour-bearing mice were treated with a purified form of a bacterial toxin, it was found that the production of chemical energy within the cancers was rapidly disrupted. Within a day tumours were quite dead, and sloughed off the bodies of the animals within two weeks. One of Nature's profoundest secrets was revealed at last; the trick is to disrupt the main source of energy of the malignant cell.
The quest for safe pharmacological alternatives began on a very modest scale. Serendipity ended the search. Anti-cancer activity is present in a number of so-called tricyclic drugs, at least one of which, Largactil, was shown in 1959 to attack energy production in tumours selectively. Most of these drugs act on the brain. In 1990 Dr Riad Mahmud, a diabetologist working in a London teaching hospital, passed on experiences gained while working at a hospital in Kuwait in the early 1970s. He had three patients with inoperable cancer of the pancreas, a painful form of cancer with a bad prognosis. Initially he gave promethazine, an anti-histamine and paediatric sedative, by the intravenous route. The drug was followed by calcium, and then given orally every eight hours. One patient died thirteen years later, but not from cancer; in 1990 the other two were still alive. Dr Mahmud was urged to publish, but before the paper could be written he died.
A safe and humane treatment for cancer based on Dr Mahmud's observations and effective in the early stages of disease became available at the end of 1994. Promethazine, the active principle of the therapy, was introduced into clinical practice in 1947 and is long out of patent. In marked contrast with standard cancer drugs, no fatalities appear to have been recorded despite widespread international use.
The first patient to adopt the procedure was a lady in her early forties with breast cancer. Through an administrative failure by the hospital she was made to wait for nine months before receiving specialist attention, by which time her cancer was well advanced. Surgery failed to remove the malignancy completely and chemotherapy produced only a transitory regression. Radiotherapy led to neuritis and caused such intense pain that she sought to have her arm amputated on the affected side. Promethazine brought permanent relief, and two of the four secondaries lodged in the bone disappeared.
Tragically the treatment was stopped prematurely after five months, far too soon. Recommencement produced no advantage, and the patient died eighteen months later. It cannot be overstressed that, once begun, the treatment has to be continued for at least six months beyond the complete elimination of disease.
The procedure was published on the internet in 1996. An updated version together with the scientific rationale is available on www.cancersupportwa.org.au/research3.php. A farmer's wife in Western Australia diagnosed with non-Hodgkin lymphoma in 1997 began the new treatment at the age of 55. Eight months later she was declared cancer-free. Unfortunately she too stopped prematurely. Nine months later her condition returned and, as in the previous case, a return to the therapy was ineffective. She underwent a variety of treatments in the hope of regaining sensitivity, including cutting gluten out of the diet. The cancer did become sensitive again but returned once more, and she died five years after the original diagnosis.
Since then a variety of cancers have displayed sensitivity to promethazine, including further cases of non-Hodgkin lymphoma and pancreatic carcinoma, a grade III astrocytoma, a chordoma, stomach cancer, colorectal cancer, Ewing's sarcoma and an instance of breast cancer with secondaries in liver and lung. Although the data are anecdotal and the patients were receiving a wide range of conventional treatments, the common factor has been that improvements began only after the initiation of therapy with promethazine. Even those patients whose cancers failed to regress have enjoyed a better quality of life and prolonged survival.
The health of sufferers has not always improved. Three patients taking high-dose supplements of vitamin E (400, 750 and 1200 units daily) failed to respond, as did others whose disease was seriously advanced. The ability of tumours to accumulate vitamin E has been known since 1940, and the protective effects of the trace nutrient now seem to extend to tumours. More serious is the intractable condition of multi-drug resistance; a single cell clone arising from a mutation caused by orthodox treatment becomes, in effect, immortal.
Simultaneous discovery is rather more common in science than the general public might believe. For a number of years Professor David Wilkie, a geneticist, suspected that the sedative clomipramine might find use against tumours of the brain. The study is still in its early days, but Professor Geoffrey Pilkington together with several clinical consultants has been obtaining encouraging results with these intractable forms of the disease.
Unexpected problems have beset introduction of the therapy of cancer with promethazine. Although the cost is less than two pounds a week, patients given the advice may decide not to proceed. Second, the attitude of the medical profession has been consistently indifferent. Letters written to doctors caring for individual patients who are getting better never receive replies; one consultant even went so far as to equate the offered advice with gossip. In sharp contrast, what is remarkable is the willingness of doctors to embark upon clinical trials with newly patented drugs which, more often than not, fail to realise the anticipated success.
Before amalgamating with the Cancer Research Campaign to form Cancer Research UK, the Imperial Cancer Research Fund was sent the rationale for the procedure in 1996. By way of response a senior clinician refrained from comment; the organisation had nobody working in that area, and there were no plans to begin. Approached at the same time, the Cancer Research Campaign preferred to place its faith in molecular biology, and looked to gene therapy to provide the solution to the problem of cancer.
Pharmaceutical companies have shown hardly any interest. Almost all tricyclic drugs are out of patent, so no fat profits can be expected from the introduction of these novel treatments. One manufacturer has argued that it would cost too much to mount a clinical trial for a return expected to be only meagre, though that has not prevented an American company from hiking the price of its generic product up last year from 3cts to a whopping 31cts per tablet.So can a solution to the cancer problem ever emerge? Imagine a cheap and humane self-treatment that works against most cancers, has a good success rate, produces so few side effects that patients can go about their business normally while sustaining the full force of the therapy, causes no deaths and is active against secondary spread. The answer to a prayer, one might think. When used exactly in the manner described, promethazine fulfils these criteria, and is moreover available in most countries without a doctor's prescription. Some, though, conclude that the idea of treating a merciless disease with a paediatric sedative is not to be taken seriously. Proof is urgently needed. Meanwhile no cancer research organisation or commercial enterprise is prepared to undertake a necessary trial. Until cancer patients themselves are prepared to take the initiative, the scourge of cancer will persist unchallenged.
Copyright © 2003 Robert Jones (updated 2008)
Reproduced with kind permission