Pancreas and Pancreatic Cancer

Editor’s note: The following information is excerpted from the totalhealth article, which ran in May 2001, Deciding to Pursue an Alternative Cancer Therapy by Dr. Linda Isaacs, Dr. Gonzalez’s partner. It serves as an excellent introduction to this first of two articles on condition specific nutrition as a primary therapy for pancreatic and other cancers.

In writing this article I drew not only upon my own experience but also on the results of a survey I sent to 50 of our long-term patients. They were kind enough to share with me some of the information about how they learned about our treatment, how they made the decision to pursue this protocol, how they motivated themselves to persevere and how they handle inquiries they receive from others about their treatment choice.

If you have been diagnosed with cancer, this is most likely a frightening time for you, bringing about radical changes in your life. Decisions about therapy may have to be made very quickly after the news is delivered. The first and most important step in your decision-making process is to learn about the disease that you have. For some patients this seems natural, for others it may be frightening or confusing. But learning about your disease, and options you have for treatment, is the first step toward choosing which option you pursue. Leaving the decision to your physicians or to your family may place you into a treatment protocol that you are unable or unwilling to put into practice or that you will subsequently regret.

The responses of the patients I surveyed for this article can be helpful because they are, for the most part, patients who have been with the practice for many years. Some of their stories can be read on our Website www.dr-gonzalez.com. Some of their cases were included in the 1993 presentation to the NCI. They had to make their decisions well before we had any published results.

Many of them initially investigated a number of treatment options but eventually they made the decision to stop searching- to settle down on one option and to pursue it to the best of their ability. As another patient wrote, “I think it’s really important to find people and treatments you trust and stick with them. I come across many people who are ill and a lot in fear and (they) keep jumping from one thing to the next hoping for an instant miracle. They are not willing to make a commitment and ‘do the work’ and they are not getting well.”

Many of them are convinced that inner resources are very important as patients embark upon an alternative therapy. Such qualities as faith, perseverance and enjoyment of life were mentioned, as well as a willingness to reach out to friends and family for help. Among their comments:

“You must be very focused with the attitude that you are running a marathon- not a sprint.”

“It has to ‘make sense’ and ‘feel right’ to the patient. The patient must be willing to do whatever she can to get well. The patient must be willing to be unsupported by the medical establishment.”

“The people who will do the best are the ones not intimidated by the medical profession and its scare tactics, these people need to know the control is in their hands not the physicians and that the patient is responsible for the healing.”

“I think a positive attitude helps, as well as a strong commitment to the program, and looking upon it as a privilege, not a punishment.”

“It truly takes someone who is willing to interrupt their status quo lifestyle and prioritize their health.”

“You need the help of others. I have six friends that organize a pill sorting party every 40 days and we have become very close.”

“I imagine the type of patient who does well on this type of approach is a person who takes time to understand health principles; believes in the program; trusts (their practitioner); is willing to make lifestyle changes, perseveres and never gives up; maintains a sense of humor; has support at home; and has a deep belief in God.”

• • Linda Issacs, M .D.

As a medical student at Cornell in 1981 I first began investigating the work of the late and very eccentric Dr. William Kelley, the dentist who developed a nutritional enzyme approach to cancer during the 1960’s. My research mentor at the time, Dr. Robert Good—then President of Sloan-Kettering and recently described in his obituary as the “Father of Modern Immunology” —suggested as part of my project I evaluate all patients with appropriately diagnosed inoperable pancreatic cancer treated by Dr. Kelley within a specific time frame (we ultimately chose the years 1974–1982). Dr. Good, wise teacher that he could be, encouraged me to focus my efforts on this particular malignancy, since pancreatic cancer was at the time, as it is today, an invidiously aggressive illness that kills most of its victims within 3–6 months. Dr. Good realized Kelley treated other types of cancers as well as non-cancer illnesses. But he felt that if I could show Kelley had even a few significant victories against this disease, his work would deserve to be taken more seriously—after all, no one in orthodox oncology anywhere could claim any success with inoperable pancreatic cancer.

In my searchs through Kelley’s files I did indeed discover a series of remarkable patients diagnosed with pancreatic cancer who had done extraordinarily well for years under Kelley’s care. I documented these unusual cases as a part of my lengthy report on Kelley’s methods, completed as fulfillment for my immunology research training under Dr. Good—who by that time had moved to All Children’s Hospital in Florida. Though the manuscript remains unpublished to this day—due to the usual biases in the medical and publishing world—by the late 1980s, long after Kelley had closed down his office and disappeared from view, word of my study and my unusual findings with pancreatic cancer spread quickly in the alternative world.

In 1993, Dr. Michael Friedman, then Associate Director of the National Cancer Institute, suggested I pursue a small pilot study, evaluating my nutritional approach in patients diagnosed with inoperable pancreatic cancer, for reasons similar to those of Dr. Good 12 years earlier. He felt that if I had the guts to put my therapy to the test against pancreatic cancer in a formal clinical trial and the treatment showed some benefit even in a few patients, the NCI would have to move to the next level with my work and support large controlled clinical studies. By “benefit” Dr. Friedman meant three out of 10 patients living one year.

My colleague Dr. Linda Isaacs and I far exceeded Dr. Friedman’s definition of success; of the eleven patients in the study, eight with very advanced stage IV disease, nine lived at least a year, five lived two years or more, and two lived beyond four years. Based on these well-documented results, published in a peer-reviewed journal in 1999, the NCI agreed to fund a comprehensive controlled study, originally designed to pit our therapy against the best available chemotherapy in patients diagnosed with inoperable pancreatic cancer. This closely followed study seems well-known within both the alternative and the orthodox medical world as one of the NCI’s first attempts to study, seriously, an alternative approach to cancer. Unfortunately, despite the earlier optimism that surrounded the project, it remains seven years later uncompleted, for many reasons that for now must be kept confidential.

So though the long story of our clinical trial must be told at some other time, while that project struggled along its peculiar pathway, we did pursue laboratory studies in a mouse pancreatic tumor model developed by the renowned molecular biologist Dr. Parviz Pour at the University of Nebraska. Again, as with the pilot study, the results were positive, impressive, published in the peer-reviewed literature, and presented at an NCI invitation-only conference.

Since so much of our research, both clinical and laboratory, has involved pancreatic cancer in one way or another, it’s understandable that many familiar with our regimen associate it primarily or even exclusively with the disease, even though Dr. Isaacs and I do treat all forms of cancer as well as non-malignant illness. Nonetheless, after several conversations with my friend Lyle Hurd, the publisher of Total Health, I decided to write about this particular disease once again, concentrating not on the clinical studies, but our success with patients treated in our private practice. In doing so I hope to demonstrate that with our nutritional therapy, a number of our patients have beaten soundly this normally rapidly terminal condition in a way unmatched anywhere in the orthodox oncology literature. I hope also to make the same point Dr. Good made with me in our first conversations about Kelley 25 years ago, and the point Dr. Friedman repeated years later. If we can document even an occasional success with inoperable pancreatic cancer, our therapy deserves to be taken more seriously.

At this point, I thought it might be useful to discuss briefly the pancreas, its anatomy and physiology, and our general treatment approach before presenting a series of case reports of patients diagnosed with the disease who have done well while under our care.

Anatomically speaking, the pancreas lies in the back-most region of the upper abdomen, technically known as the retroperitoneum, directly behind the stomach. Here it sits literally fused to the posterior body wall, lying horizontally along it. In the adult, the organ is about 10–15 cms (5–6 inches) in length with a tapering shape consisting of a widened head, a narrowing body and still more narrowed tail. In one of my lectures years ago, I suggested that the pancreas looked somewhat like the head of a seagull or tern, with its head and tapering beak. I think that analogy a good one, even today.

The pancreatic head fits snugly in the duodenum, the first part of the small intestine into which the partially digested food flows from the stomach after each meal. The duodenum itself has a well-described “C curve” shape that wraps around the pancreatic head and receives the bolus of pancreatic enzymes that continue the digestive process.

In its microscopic structure, the pancreas consists of two very distinct cell types, those of the exocrine pancreas that synthesize the digestive enzymes, and the endocrine cells that manufacture various hormones. The exocrine cells far outnumber the endocrine, making up about 90 percent of the organ’s total cell mass. These enzyme producers array themselves in nests called acini, the production centers for the main classes of pancreatic enzymes: the proteolytic group including trypsin and chymotrypsin that break down large proteins into their component amino acids; the lipases, that chop up long chain fatty acids into smaller molecules; and the amylases, that cleave complex carbohydrates into sugars such as glucose and fructose. The pancreas actually secretes many enzymes in each class, and dozens overall.

The acinar cells synthesize and secrete the powerful proteolytic enzymes and the lipases as inactive precursor molecules lacking any digestive capability. Consequently, these dormant molecules pose no threat to the pancreas itself, which otherwise could be digested away. But once released into the duodenum, the precursors quickly transform into active enzymes, ready and willing to attack any food that might be arriving from the stomach.

The scarcer endocrine cells also lie in nests, known as isles of Langerhans, that lie scattered throughout the pancreas, though they tend to be concentrated in the tail region. Scientists recognize three categories of islet cells, each of which synthesizes a particular hormone. The alpha cells secrete glucagon, which stimulates the liver and muscle to release stored carbohydrates as the need arises, such as between meals or when food is scarce. Beta cells manufacture insulin that serves to drive excess blood glucose into cells for use as energy or for storage during and after a meal. Delta cells produce somatostatin, which regulates the synthesis and activity of the other two islet hormones. All the endocrine cells release their respective hormone molecules directly into the bloodstream, for use at distant tissue sites such as the liver and the various muscles of the body.