COLEY's TOXINS - RalphW.Moss - Cancer Chronicles

RalphW.Moss - Cancer Chronicles

The Cancer Chronicles

PLEASE READ THIS (easier reading)
http://www.ralphmoss.com/html/coley.pdf


THE SUM OF OUR HOPES THE TREATMENT OF CANCER WITH COLEY’S TOXINS

Coley’s toxins are a century-old immunologi-
cal treatment for cancer. It consists of the
injection into the patient of by-products of
two common bacteria, Streptococcus pyo-
genes and Serratia marcescens. The treat-
ment has also been known as "Coley’s fluid,"
"Coley toxin," or "mixed bacterial vaccine."
It was developed by an eminent New York
surgeon named William B. Coley, MD, who
spent most of his long career as chief of the
Bone Service at Memorial Hospital (now
Memorial Sloan-Kettering Cancer Center).
The therapeutic idea was to deliberately
and repeatedly invoke fevers, as high as 105º F,
as well as chills and other "flu-like" symptoms
in the cancer patient. The rationale was to
provoke the immune system to attack and
destroy the cancer.

HISTORICAL BASIS

This treatment did not come out of a vacuum.
In the eighteenth and nineteenth centuries
it was repeatedly observed that following
serious infections cancer patients sometimes
experienced "spontaneous remissions" of
their malignancies. The diseases usually
linked in this way to cancer were tubercu-
losis, malaria, and syphilis.

In 1866, a celebrated German surgeon,
Wilhelm Busch of Bonn, reported on the
spontaneous cure of cancer after an attack
of erysipelas (Berlin klin Wchnschr 1866;
23:245). This is a serious skin disease which
we now understand to be caused by the
microbe called Streptococcus pyogenes.

Busch was well-respected and word of his
observation spread rapidly. After that, many
attempts were made to artificially stimulate
either erysipelas or high fevers in cancer
patients. As one of Busch’s students, Willy
Meyer or New York, later wrote, "A great
variety of substances, from almost all the compounds of
chemistry to plain water, have since then been injected,
some of them with fever as a by-product" (Cancer,NY:
Hoeber, 1931, p. 343).

The link between the onset of erysipelas and the
"spontaneous" remission of cancer was noted in the
1880s. Even the Russian playwright Anton Chekhov,
who was also a physician, noted the relationship in his
diary in 1884.

In fact, over a dozen doctors on the Continent (mostly
Germany) tried to induce erysipelas to bring about
remissions in their patients. Most failed to even induce
the disease; but some of these attempts appear to have
been successful.

In a similar vein, a well-known French surgeon, Marin
Tuffier, MD, brought about the remission of "terminal"
breast cancer in a 37-year-old actress by giving her injec-
tions of a purified fraction of her own pleural exudate
(lung fluid). Whether the woman benefitted from the
fevers that ensued, or whether there was an enhanced
immune reaction to some cancer antigens—or both—
was never established. The woman left his care in greatly
improved health, although there was no followup.

One big problem was that most fever-causing sub-
stances lost their potency after a short while. So, by the
end of the nineteenth century, a worldwide search was on
for a serum "of such range of dosage, without bad side-
effects" which could put the patient "without fail and
without interruption" in a state of fever (Meyer, p. 344).
That serum turned out to be Coley’s toxins.

NINETEENTH CENTURY LINK

Coley made his discovery without knowledge of these
previous European findings. In 1891, he was a young man
fresh out of Yale College and Harvard Medical School.
His first bone cancer patient was a lovely 19-year-old girl
named Bessie who had a sarcoma of the bone. (She also
happened to be the girl friend of John D. Rockefeller, Jr.;
on a personal level, many biographers say that this was
the origin of the Rockefeller family’s continued involve-
ment in the cancer field.) Although Coley did everything
according to the textbooks, the girl had a recurrence of
her cancer and died.

Determined to find out why "orthodox" methods of
surgery had failed, Coley examined the records of 100
sarcoma patients who had been treated at New York
Hospital. All advanced cases died. Eventually, however,
he found the case of a man who had been operated on
three times with no success; but the fourth incomplete
removal of his tumor in 1884 resulted in a raging case of
erysipelas, with its angry-red inflammation of the skin.

TRACES DISAPPEAR

Hospital records simply stated that all traces of the
tumor had disappeared following the infection.
Intrigued, young Coley traipsed up and down the tene-
ments of New York’s East Side and found the man, alive
and well, in 1891. This was seven years after he had been
"spontaneously" healed of his cancer.
Fascinated by the vistas that this "experiment of
nature" opened up, Coley reviewed the evidence for
erysipelas healing in the prestigious Annals of Surgery
(1891;14:199-200). Thus began his life-long search for a
cancer cure using the organism that causes erysipelas.
In October 1891, Coley took the fateful step of deliber-
ately infecting a patient who had an inoperable cancer of
the tonsils and neck with Streptococcus pyogenes, the
organism that had only recently been discovered to
cause erysipelas. Much to everyone’s astonishment,
after severe fevers and chills, the patient experienced a
complete and prolonged remission of his cancer.
Coley thought he was the first person ever to do this,
but we now know he was actually the fourteenth—
but the others had all been in Germany, and Coley was
unfamiliar with the world literature on the subject.
As usually happens with new cancer treatments,
after the initial first success there followed a
string of treatment failures. Coley’s procedure was to
put patients in so-called "erysipelas beds," which had
recently been vacated by patients who had just died of
the disease. But because live strep infections were
potentially dangerous to both patients and health care
workers, in 1893 Dr. Coley switched to injections not
of live germs but of the non-infectious byproducts
(so-called "toxins") of Streptococcus pyogenes.

At about the same time, a French scientist named
G. H. Roger showed that if strep is grown together with
a second microbe, now called Serratia marcescens, the
virulence of the strep is greatly increased (Séances et
Mém Soc de Biol Paris 1890;2:573-580). Roger was so
impressed with its enhancing ability that he called this
"Bacillus prodigiosus." For this reason, Coley added
Serratia to the mix, creating the classical Coley’s toxins.
The first patient to receive these toxins had an exten-
sive and inoperable sarcoma of the abdominal wall and
the pelvis, already involving the bladder. Coley injected
his toxins for four months into and around the tumors.
(In the early days, he generally favored intra-tumoral

"All therapeutic cures are obtainable only by the
working of physiological forces and the first hope of
therapeutic success comes with the observation of
the efficiency of unaided nature to accomplish
cure....These cases, rare though they be, are the
sum of our hopes."— Pearce Gould, MD, 1910

and peri-tumoral injections.) Even without using live
bacteria, he was able to cause a complete remission of
the "incurable" cancer. The patient remained alive and
well for 26 years, when he finally succumbed to a heart
attack.

Around 1915, Coley became chief of the Bone Service
at Memorial [Sloan-Kettering] Hospital, the world’s
largest private cancer center, where he remained until
his death in 1936. He was highly respected and honored,
and over 400 scientific papers were written about his
toxins. The treatment was used experimentally not
just in the United States, but in Canada, the UK and
Belgium. He kept giving it until 1936, when his son
Bradley took over his position and practice at Memorial.

THE 896 CASES

In all, they and their colleagues in the US and Europe
treated several thousand cases. Since 1939, Coley’s
only daughter, Helen Coley Nauts, has been
documenting the results of her father’s work and
expanding on its meaning. Although she is in her late
eighties, she continues to do so. Mrs. Nauts has now
analyzed in detail the outcomes of 896 microscopically
confirmed cases. Of these, 428 cases (roughly half) were
found to be well from 5 to 92 years after treatment. The
overall 5-year survival rate was 51 percent in operable
cases and 46 percent in inoperable ones. This compares
favorably to any treatment of the current day. Five-
year-survival is the conventional definition of "cure."
Amazingly, some of his cured patients may still be alive.
I myself was speaking about alternative cancer treat-
ments on a talk radio show in Scottsdale, AZ a few years
ago. I received an excited call from a man whose voice
revealed him to be quite elderly. He wanted to tell me
about his cure from cancer of the shoulder back in 1912.
He (and the audience, I presume) were quite amazed
when I beat him to the punch and told him both the name
of the doctor who treated him and the nature of the
treatment!

In fact, Coley’s toxins were quite well-known and
well-respected. In 1931, the New York cancer specialist
Willy Meyer, MD, wrote, "Coley’s fluid…is so well known
and has been so widely in use in cancer, and for so many
years, that is appears superfluous to enter here until
historical and other details regarding the same. There is
a rich literature dealing with the results obtained with
the fluid in numerous cases" (op.cit.).
James Ewing, MD, chief pathologist at Memorial
Hospital, was both conservative regarding new treat-
ments, and a powerful rival of Coley’s at that cancer
center. He represented the least favorable end of the
spectrum of evaluation. Yet he wrote, "[I]n some recov-
eries from endothelioma of the bone, there is substantial
evidence that the toxins played an essential part"
(Neoplastic Diseases, 6th ed., Phila.: Saunders, 1941, p.
314).

LESSONS FROM HISTORY


The history of Coley’s toxins is thus both inspiring and
instructive. It shows that in the past there were experi-
mental treatments available that exceeded in efficacy
some of the best modern treatments. Various forms of
cancer that we today consider incurable were sometimes
put into long-term, lasting remissions.
Patients understandably want to know how this can
be. If a treatment was once effective why is it not now
in common use? Answers vary. Some people continue
to deny the reality of the claims. Or they state that
Coley’s toxins are too dangerous to use. I have heard a
researcher who is otherwise favorable towards alterna-
tives tell a patient that since Coley’s toxins have been
around for 100 years they would have been widely
accepted if they were any good.

Coley’s toxins seem doomed to the "twilight zone"
of effective but underexplored cancer treatments.
I deal in detail with these issues in my book The
Cancer Industry. I think the barrier to their use is
primarily economic. The production of Coley’s toxins is
remarkably inexpensive. Making a six months’ supply
comes to about one dollar! But the cost of working a
new drug through the regulatory barriers average about
$230 million. Coley’s toxins are not patented, and there is
simply no way to make back your investment, much less
turn a profit, on this treatment.

Historically, the toxins were once produced by Parke-
Davis and other companies. But they were forced out
by chemotherapy. And although a number of pharmaceu-
tical companies have occasionally expressed an interest
in researching the toxins, this interest usually abates as
they quickly understand the economics of the treatment.
There is now intense interest in Coley’s toxins among
doctors in Germany, Sweden and China, as well as the
United States and Latin America. Principal credit for
survival of this treatment goes to Mrs. Nauts, as well as
to Mr. Wayne Martin, an octogenarian science writer
who has been researching this topic since 1932.


FOUR STAGES

The history of Coley’s toxins can be divided into four
stages.

In the first stage, what we can call the "golden age" of
treatment, 1891-1936, Coley used either erysipelas or
the toxins to treat cancer at Memorial Hospital, and
dozens of colleagues did likewise. The results were
mixed: sometimes spectacular, sometimes failure.

In the second stage, 1936-1963, Bradley Coley, MD
took over the Bone Service of Memorial after his father’s
death. He and a few colleagues continued to give the
treatment, but with increasing opposition from the
forces representing both radiation and especially
chemotherapy. The treatment was summarily banished
from Memorial in 1955. Many patients were cut off from
their medicine at that point. In the fateful year 1963, the
Food and Drug Administration (FDA) refused to
"grandfather" Coley’s toxins, as a pre-existing medicine,
the way it had done for aspirin and innumerable other
products. That one act made it illegal to sell the toxins in
the United States. At this point, the method was added
to the American Cancer Society’s "unproven methods"
list, in effect declaring it quackery.

In the third phase, 1964-1994, Coley’s toxins became
virtually unavailable. After a decade, Mrs. Nauts and her
scientific director Lloyd Old, MD of Sloan-Kettering
Institute, did manage to have the method removed from
the ACS list. Mrs. Nauts also completed publication of
her historic series of 18 monographs on the true accom-
plishments of the treatment. She was able to find 896
such cases. Mrs. Nauts’ greatest achievement was to
meticulously document the outcomes of these patients.

Anyone involved in evaluating non-conventional cancer
treatments will appreciate the enormity of this job.

She completed many other great scholarly tasks, not
the least of which was figuring out what the conditions
were for the successful application of the treatment.

During this period, Charles Starnes of Amgen, Inc. also
took and interest in the toxins and published on them in
peer-reviewed journals (Pharmac Ther 1994;64:529-564).

I first wrote about the toxins 20 years ago when I
was still at Memorial Sloan-Kettering. It is prominently
discussed in The Cancer Industry, as well as Cancer
Therapy, where I attempted to give the public some idea
of the successes that had been achieved with the method.

The current period began around 1994. During this
period, Coley’s toxins have become more widely used,
especially in various parts of Latin America, thanks in
good measure to the efforts of Wayne Martin.

READ Wayne Martin's ARTICLE, NEXT POSTING IN THIS BLOG

THE SEVEN KEYS TO SUCCESS

Certain well-delineated factors made for success or fail-
ure in the use of Coley’s toxins. Some of these are under
the control of the treating physician. Others can be influ-
enced by the patient. It may be possible, by carefully
studying these factors, to optimize the chance of a long-
term "cure" using this method.
Mrs. Nauts’ careful analysis of the cases reveals seven
factors that influence whether or not the patient is likely
to be cured.We now know that many cases in the past
were inadequately treated. These are:
1. Stage of disease and/or magnitude of tumor burden
2. Immune competence of the patient
3. Potency of various preparations
4. Site of injection, i.e. close contact with tumor cells,
whenever possible
5. Dosage, frequency and duration of injections
6. Timing in relation to surgery, radiation
and/or chemotherapy
7. Febrile reactions
We shall deal with each of these in turn.

1 STAGE OF DISEASE/BURDEN

As with any form of cancer treatment, the earlier in the
disease process that the patient can be treated, the
greater will be the chances of success.
Put another way, patients in the earliest stages of
their disease (with small and/or non-disseminated
tumors) do better than those who already have
inoperable or metastatic disease.
Patients who began the Coley treatment when they
had primary, operable tumors over-all had a 71 percent
five-year survival rate. But when metastases were
present, this was reduced to 28 percent.
Among moribund cases there were no long-term
survivors, although palliation (reduction in pain,
improvement in appetite and weight, better facial color,
feelings of well-being, etc.) was usually achieved.

2 IMMUNE COMPETENCE OF THE PATIENT

Coley is regarded as a pioneer of cancer immunotherapy.
Without fully functioning white blood cells there is less
chance that Coley’s toxins will work. The status of the
patient’s immune system is thus a major deciding issue.
Prolonged illness, advancing years, or the cancer itself
may weaken the immune system. But nowadays it is
more likely that the patient’s immune system has been
compromised by extensive surgery, radiotherapy and
especially chemotherapy.
For that reason, we have to face the possibility that
some of today’s patients have less likelihood of
being cured by this treatment than were patients
described in the historical record.
Of course, we must remember that patients respond in
an individual way to treatments, and it is difficult to say
who is immune compromised and who is not. One sign of
compromise, however, is that the patient can no longer
react with a fever after the injections of highly antigenic
material such as Coley’s toxins. This is not uncommonly
seen in today’s advanced cancer patient.
According to Mrs. Nauts, "many of the inoperable or
terminal breast cancer patients treated after Coley’s
death in 1936 received [Coley’s toxins] after having had


Newcastle Disease Virus Vaccine (MTH-68)

What is Newcastle disease?

Newcastle disease (ND), also known as "avian pneumo-
encephalitis," is a veterinary disease characterized by
respiratory difficulties and nervousness in both water-
fowl and domesticated poultry. Some adult birds do
recover from ND but the mortality rate is high, and
infected chicks almost never survive. The disease is
caused by the Newcastle Disease Virus (NDV), a Type 1
paramyxovirus, broadly similar to the one that causes
mumps in children. While there is no effective treatment
for this "fowl plague," for decades preventative vaccines
have been routinely available for veterinary use.

Does NDV cause any human diseases?

NDV itself is considered either apathogenic or just
minimally pathogenic in people. According to the
Encyclopedia Britannica, "humans can become infected
by handling sick birds but usually develop only a tempo-
rary conjunctivitis (inflammation of the mucous mem-
brane lining the inner surface of the eyelid." In actual
practice, "pinkeye" is a relatively rare effect (see below).
What is the history of using NDV as a treatment?
In the early 1960s, a form of Newcastle Disease Virus
(NDV) was directly injected into several uterine cervical
squamous cell carcinomas. These underwent partial
necrosis (cell death) and sloughing of tumor, which
unfortunately was followed by tumor regrowth (Cassel,
WA and Garrett, RE. Cancer 1965;18:863-868). This
regrowth might have been due to the formation of
natural antibodies against the virus. W.A. Cassel and
colleagues used the 73-T strain of NDV, which had been
passed through mouse Ehrlich ascites carcinoma cells.
It is possible that the original viral strain was modified
in this passage, possibly by a natural "recombination"
with a parvovirus from the mouse.

Who is the principal pioneer of NDV treatment?

The principal pioneer is an Hungarian-American physi-
cian, Laszlo Csatary, MD (pronounced LASS-low
Sha-TAR-ee). Dr. Csatary became interested in this
topic in medical school in Hungary. He was intrigued by
the fact that Hungarian farmers rarely got cancer. He
theorized that they not only lived a healthier life style,
but that some agent might be present in their rural envi-
ronment that either prevented or cured cancer. He rea-
soned that since the fatal human disease smallpox was
prevented through vaccination with the cowpox virus
(harmless to humans), there could also be some unknown
viral agent that could perform the same role in cancer.
When he came to the United States, Dr. Csatary had a
chance to put his theories to the test. In 1968, as a physi-
cian at the Jefferson Memorial Hospital in Alexandria,
VA, he began to treat advanced cancer patients with a
modified strain of NDV. He published a letter in the
Lancet (1971;2:7728;825) about the spontaneous remis-
sion of metastatic stomach cancer in a Hungarian
chicken farmer at the same time as an epidemic of
Newcastle Disease in his flock. Dr. Csatary believed
this remission was due to interference by the NDV
with another cancer-causing virus. With his wife,
Eva, Dr. Csatary eventually produced a medicine called
MTH-68, which a carefully crafted variant on the
NDV virus vaccine.

Csatary has since published a number of other articles
on this topic (e.g., Cancer Detection and Prevention
1993;17:619-627). This reports on a phase I/II double-
blind clinical trial performed in Hungary under the
direction of Sandor Eckhart, MD, past president of the
International Union Against Cancer. Dr. Csatary is
currently the director of the United Cancer Research
Institute, which was founded to promote research into
viral therapies of cancer.
Supporting animal work has also been done in the US
by Dr. L.N. Tauber as well as by R.M. Lorence and col-
leagues at Rush-Presbyterian in Chicago. These have
been published in the Journal of the National Cancer
Institute and Cancer Research, and were favorably
reviewed in an editorial in the JNCI in 1994 (Kennedy, S
and Pagano, JS. JNCI, 1994;86:1185-1187).

What is MTH-68?

MTH-68 is a biological product derived from the "H"
strain of the attenuated NDV vaccine. The "H" strain
was attenuated (somewhat weakened) in Great Britain
in the 1930s by serial passage of a more virulent strain
through eggs. This particular strain was originally
obtained from the Veterinary Research Institute of the
Hungarian Academy of Sciences.
It is sometimes erroneously stated that MTH-68 is
nothing but a commercially available strain of NDV. This
is not true. Csatary’s vaccine has been made in Hungary
through a specially designed manufacturing process,
which includes restriction enzyme analysis, cloning,
purification and concentration, and lyophilization.
One should therefore not identify MTH-68 as ordinary
NDV. Even subtle differences in strains can produce
profoundly different effects. Some strains are
September 1996 The Cancer Chronicles 7 ineffective. Others have variable effects on the growth of
tumors in the presence of antiviral antibodies (Sinkovics,
JG and Howe, CD. Experientia 1969;25:733-734). Yet
others could conceivably be deleterious.
By contrast, MTH-68 has well-defined genetic and bio-
logical characteristics. Work on this was done by Hun-
garian scientists and the product is manufactured there.
It meets the stringent World Health Organization
(WHO) standards for such products. The final product is
a purified version of the virus which is suitable for use in
human cancer patients.

Could MTH-68 be harmful?

There is no indication that it is. But remember that
MTH-68 is an experimental treatment, which by
definition means that no one knows the full panoply of all
its possible effects. We do know that conventional
chemotherapy can and does cause many harmful side
effects, sometimes including cancer itself. MTH-68 is not
chemotherapy and does not work in the same way or
share any of its other characteristics. However, one must
always consider the risk vs. benefit ratio in utilizing this
or any other treatment.

Does MTH-68 cause side effects?

MTH-68 sometimes does cause one particular side effect
in patient, i.e. fevers. In one placebo-controlled study in
Hungary, two thirds of the vaccine-treated patients had
no negative side effects. But fever (in the range of 37° to
39° C, i.e. as high as 102.5° F.) was seen in 8 out of 33
patients following inhalation of the virus. This fever
subsided within 24 hours. In the majority of such cases,
repeated inhalation then caused only a moderate or
low-grade fever. Two patients had low grade fever for
24 hours following inhalation of the virus. Fever is not
necessarily a bad thing in cancer. Other treatments, such
as hyperthermia and Coley’s toxins (mixed bacterial
vaccine), hope to raise the body temperature in order to
disorganize and destroy cancerous tissue.
Conjunctivitis is the side effect most commonly
discussed in relation to NDV exposure. But this is rarely
seen in the clinical setting. One Healing Choices consul-
tee did develop "pink eye" after taking the virus, but this
may have been coincidental, since he was a child who had
been exposed to other children with this condition just
prior to this incident.
Can MTH-68 be injected?
In 1968, Csatary injected the vaccine intravenously (IV)
and there were outstanding clinical results when it was
used in this way. Unfortunately, they had to abandon the
use of this IV vaccine after one patient developed a
severe anaphylactic (allergic-type) reaction from it. Only
recently have they been able to purify the vaccine to
make it safe enough for intravenous use. This could open
up a new era in the use of safe and effective injected
Newcastle Disease virus treatment.
At the present moment, however, the medicine is
being taken either nasally as a spray or drip, or rectally
as a suppository. (Final approval of the IV form in Hun-
gary is in process.) The medicine comes in a powder
form, which is mixed with a saline solution before one
takes it. It takes only minutes to administer.
An intravenous version of the medicine has been
developed according to World Health Organization
(WHO) specifications. Toxicological and phase I (safety)
studies are now underway on this in Hungary. This
should be a big advance: presumably more effective,
with smaller doses and lower prices for the patients. The
IV form of the drug is sometimes given by nebulizer.
Once Phase I studies are completed, this is promised to
be available and will probably be sold in Hungarian phar-
macies. Under no circumstances should patients attempt
to inject the MTH-68 meant for application by inhalation.

How credible is this work overall?

For most of his life, Dr. Csatary was a working physician,
not a full-time research scientist. He paid for the devel-
opment of this treatment out of his own pocket, from a
humanitarian motive. For 25 years he only administered
this treatment when and where he was legally entitled to
do so, and never charged for the treatment.
His work has sometimes been criticized for lacking
the kind of sophisticated detail that some more rigorous
academic studies possess. With greater resources, how-
ever, such studies (e.g., on the precise immunological
modifications caused by the treatment) could undoubt-
edly be performed. Nevertheless, in contrast to most
"alternative practitioners," Dr. Csatary has all along
published in standard medical journals, including the
Lancet, considered one of the best medical journals in
the world.
On a personal note, I was first led to the Csatarys’
work by a former official of the Hungarian government,
well known to me, who told me that he had been
completely cured of a severe genital herpes condition
by this treatment. His own father, he said, had been
cured of prostate cancer on it. (The father recently
celebrated his 84th birthday.)
I made a trip to visit Laszlo and Eva Csatary in the
early 1990s and have spoken to them regularly over the
last four years. I have also spoken to many of their
patients, and have been provided with summaries of the
medical records of others. They have been extremely
forthcoming in providing me with the data I seek. I
believe they are credible and honorable people who are
truly dedicated to the welfare of patients. The scientific
evaluation of MTH-68 should be a high priority of the
government’s war on cancer
.
Can this approach be used to treat other illnesses?

Dr. Csatary presents credible data that similar products
can also be used to treat other diseases of viral origin,
including herpes infection and hepatitis B. The theoreti-
cal basis of such treatments is as follows: chickens are
afflicted with a cancer-like illness caused by herpes
viruses. This is called Marek’s disease. Csatary and his
colleagues gave both Marek’s disease and a human myx-
ovirus, influenza A, to birds in an attempt to study how
they interfere with one another. Birds which had been
exposed to both viruses recovered, whereas those which
contracted only Marek’s disease all died. The rate of can-
cer-like changes in the blood was cut in half. And of those
that did develop cancer, there were "less severe lesions."
(For more details, see Cancer Therapy, pp. 439-440).
To treat other illnesses other viruses are currently in
use. Thus, they are using an attenuated variant of the
Bursal Disease Virus (BDV), called MTH-68/B, to treat
hepatitis B. In a placebo-controlled study of 84 patients
Hungarian patients with acute B (43 patients) and C
(41 patients) viral hepatitis, MTH-68/B reduced the
frequency of relapses and decreased the number of cases
progressing to chronic hepatitis. This work was reported
at the Clinical Immunology Society meeting in February,
1996.
Of the 43 patients with Hepatitis B, 15 in the control
group progressed to chronic active hepatitis, while none
in the treatment group did so. There were long-term (six
month or more) remissions in the control group, com-
pared to 4/19 or 23 percent in the treatment group.
What is the relationship of viruses to cancer?
It is contradictory. On the one hand, it is well-established
that many animal cancers are caused by specific viruses
(e.g., the feline leukemia virus). More and more human
cancers (e.g. Burkitt’s lymphoma) are either known or
strongly suspected of also being caused by viruses. It
may be that viruses play a yet undefined role in initiating
or promoting a great many human cancers.
At the same time, viruses are a two-edge sword, for it
appears likely that one can utilize viruses in the fight
against cancer. It is an old observation, but a profoundly
true one, that tumors tend to soak up infectious agents.
("The tumor functions as a sponge," according to C.
Levaditi and S. Nicolau, writing in the French Annals of
the Institut Pasteur 1923;37:1-3.)
The idea of using viruses to attack cancer is new to
most people, but it has been repeatedly suggested and
tried for over 100 years. As several researchers have
written, this idea "repeatedly emerges reinvented anew
and abandoned, just to reappear again in the most recent
literature" (Sinkovics, JG and Horvath, J, Medical
Hypotheses 1995;44;359-368).
There are many well-documented cases in the medical
literature of cases of cancer that disappeared after
natural viral infections with such diseases as measles
or hepatitis A. In 1893, another Hungarian, F. Kovacs,
described the regressions of leukemia that followed
various kinds of viral infections (Wien Klin Wochenschr
1893;6:701). These have generally been dismissed as
imponderable "spontaneous remissions."
A 1912 scientific article generated much interest when
it reported on a woman whose carcinoma of the uterine
cervix regressed after she received a vaccination with an
attenuated (i.e., weakened) strain of the rabies virus
(DePace, NC, Ginecologia 1912;9:82). In continental
Europe, throughout the early decades of this century,
sporadic attempts were made to treat advanced cancer
patients with both native viruses and vaccines.
In the United States in the 1960s, Dr. Chester
Southam, a celebrated immunologist at Sloan-Kettering
Institute and colleagues, tried to use the measles and
other viruses to induce remissions in Hodgkin’s disease,
Burkitt’s lymphoma and acute lymphocytic leukemia
(ALL). There were some good results, but one child with
cancer may have died from the after effects of this
measles treatment (Laski, B. JAMA 1973;225:1303).
Following that, there was diminished interest in this
approach.
Sporadic work still continues along these lines in a
number of countries. In China it has been found that a
combination of chemotherapy, BCG (a standard immune
stimulant), and the measles vaccine brought about a
complete response rate of 79 percent in leukemia com-
pared to a rate of 31 percent using chemotherapy alone
(Yu Zhifei, et al. Chinese Med 1981;94:31). This work has
not been followed up on in the West. Perhaps the best-
known use of viral therapy has occurred in Japan. There,
starting in the 1970s, a Japanese scientist, T. Asada, used
live mumps virus to treat 90 patients in an uncontrolled
study. He claimed that 79 of these (87.7 percent) had
either regression or stabilization of existing tumors
(Cancer 1974;34:1907-1928). Again, there is been no
adequate follow-up of this work in the West.

Have other types of viruses been used as therapy?
Yes, other viruses have also been used successfully from
time to time, including varicella (Bierman, HR, et al.
Cancer 1953;6:591); attenuated yellow fever virus and
hepatitis A (Weintraub, LR. JAMA 1969;24:1590); small-
pox vaccination (Hansen, RM and Libnoch, JA. Arch Int
Med 1979;138:1137 and DeStefano, AD and Buzdar, AY.
Arch Int Med 1979;139:946). In fact, we now realize that
many of the "spontaneous remissions" reported in the
literature followed known or suspected viral infections
(Sinkovics, J. Ann Immunol Hung 1986;26:271-290).
Is this work supported by laboratory studies?
Parallel to the clinical reports, and sometimes stimulated
by them, have been some rather spectacular reports of
both in vitro (test tube) and animal studies, starting in
the 1920s (e.g., Molumut, N, et al. JNCI 1965;34:403 and
Wheelock, EF. PNAS 1966;55:774).
Scientists have demonstrated a pattern of "interfer-
ence" between common viruses and cancer-causing
(oncogenic) viruses that could account for these effects
(by the mid-1950s, 50 such papers had been published).
Soon after the first cytokine, interferon, was discovered
in 1957, it was recognized as a major mediator of such
interference. Interferon itself was found to suppress the
replication (reproduction) of both cancer-causing viruses
and of cancer cells themselves. At the same time it has
been found that cancer tissue itself exerts an interferon-
suppressing effect (Sinkovics, JG, et al. Experientia
1968;24:927)
In still unpublished results from 1996, Hungarian sci-
entists demonstrated pronounced antiproliferative
effects when MTH-68 was incubated with different
human tumor cells. The strains used were the HT29
human colorectal tumor, the MCF7 human mammary
tumor and the PC3 human prostatic cancer cells. They
were "altered remarkably" when they were infected by
different doses of the live Newcastle disease virus, while
the proliferation of normal human fibroblast cells was
not affected by this treatment. In particular, it was found
that the highest dose of the virus (107 EID50/ml) caused
the destruction of 81.7 percent of the breast cancer cells,
75.8 percent of the colorectal and 32.2 percent of the
prostate cancer cells after 48 hours incubation. By
contrast, only 11.6 percent of the normal human fibro-
blasts were killed by such incubation. M
For further information on MTH-68:
See Ralph W. Moss, Ph.D., Cancer Therapy, Equinox
Press, Brooklyn, New York 1996, pp. 437-445. See also
chapter on "Coley’s Toxins," a somewhat related bacte-
rial product, in Ralph W. Moss, Ph.D., The Cancer Indus-
try (Equinox Press, 1996). To order these books, ask
your bookseller or call the publisher at 1-718-636-1679.
Ralph W. Moss, Ph.D. is the author of eight books
(The Cancer Industry, Cancer Therapy, Questioning
Chemotherapy, etc.) and three documentaries on cancer-
related topics. He is an advisor on alternative cancer
treatments to the National Institutes of Health,
Columbia University, and the University of Texas.
He researches and writes individualized "Healing
Choices" reports for people with cancer. For information
on Healing Choices, you can contact coordinator Anne
Beattie in the following ways:
HEALING CHOICES REPORT SERVICE
Coordinator Anne Beattie
Address 144 St. John’s Place, Brooklyn, NY 11217
Phone 718-636-4433
Fax 718-636-0186
E-mail equinox@walrus.com
Web site http: / /www.walrus.com/~equinox/ radiation and/or chemotherapy. Although no cures were
obtained,marked palliation, regression, decreased
pain… and weight gain occurred in many of these
patients" (italics added).
One possibility might be for the patient to take
various immune-stimulating substances (such as the
Chinese herb Astragalus membranaceous, which is
widely available in health food stores) as a way of
boosting the immune response.
Another confounding factor that could affect the
outcome of Coley’s treatment is the widespread use of
antibiotics in medicine and agriculture since the 1940s.
Antibiotics, the "wonder drugs" of the postwar epoch,
are clearly a two-edge sword.
Immunity is "a mechanism that has been acquired and
perfected through millions of years of evolution" wrote
B.A. Meyer and J.D. Benjafield forty years ago. Yet
incessant treatment with antibiotics may interfere with
that mechanism.
"The antibiotics may absolve the body of the need to
bring the normal immunological mechanisms into use"
(Med. Press 1955:234:206-208). Such criticisms of antibi-
otics, once highly controversial, are now more common.
"The widespread and often indiscriminate use of
antibiotics" has "created drug-resistant Gram-negative
bacilli that readily acquire multiple resistance...." says a
modern textbook. "Prolonged antibiotic therapy compro-
mises this defense mechanism" (Baron, S., ed. Medical
Microbiology, 4th ed., U. of Texas, Galveston, 1996:348).
It it thus also possible that optimal results with
Coley’s toxins could be diminished by the side effects of
long-term use of antibiotics.
Again, we should be prepared for the possibility of
less dramatic results than were achieved 100 years ago.
3 POTENCY OF VARIOUS PREPARATIONS
Coley’s toxins are a manufactured item. And while
making them is not "rocket science," they do have to be
prepared with both knowledge and care. To put it mildly,
this has not always been the case.
Coley himself, while an eminent surgeon, was not a
microbiologist, and always relied on others to make the
preparations for him. When those others were knowl-
edgeable and scrupulous technicians, clinical results with
the toxins tended to be very good.
But when they were not, the preparations were either
less effective or virtually worthless.
It was found that a weak preparation could usually be
compensated for by an increase in the dosage. But some
preparations actually appear to have been totally inert
and the long-term remission rates achieved with them
were virtually zero.
This one variable led to a great deal of confusion, skep-
ticism, and chagrin among Coley’s medical colleagues,
even his erstwhile supporters. And this skepticism has
been passed, like an infection, down through the decades.
Historically, there have been several different ways of
making Coley’s toxins. First, as we have seen, Coley just
injected live strep organisms (obtained from the labora-
tory of "microbe hunter" Robert Koch).
This was effective but too dangerous to use.
Following this, Coley’s colleague, Alexander Lam-
bert, made preparations of toxins for him from killed
streptococcal germs. Lambert made beef broth, grew
the strep in the broth for several days, and then steril-
ized it with heat to destroy any living microbes (Proc.
Royal Soc. Med, Surgical Section 1909-1910:1-48).
Coley was always interested in increasing the "punch"
of his products and so he asked another colleague, B. H.
Buxton, Fellow of Bacteriology at the Loomis Labora-
tory and later Professor of Experimental Pathology at
Cornell University, to make up a mixture of strep and
the aforementioned Serratia marcescens.
Buxton grew the two microbes together in the same
flask. But one cannot just grow them together, however,
because strep grows best at 36 º C (about 97º F), while
Serratia likes to grow in a cooler medium.
Buxton therefore grew the strep by itself for ten days
and only then added Serratia. The two were then grown
together for another ten days at 25º C (about 77º F).
After this total of 20 days, the germs were all killed by
heat. But it was also observed that the lower the temper-
ature used to sterilize the mixture, the stronger was the
resulting product.
On the other hand, too little heat could leave the
microbes, and especially the potent Serratia, alive and
kicking. The injected mixture could theoretically infect
the patient, with disastrous results.
Because of this fear, some technicians, then and now,
overheated the product in order to make sure that they
killed every last Serratia germ. But there was a price for
such caution, for this overheated preparation also had
little anticancer activity.
Thus, ironically, some technicians inactivated their
own preparation, out of excessive caution.
TRACY FORMULA
Coley used Dr. Buxton’s formula until 1916. Then he
switched to a new kind of formula produced by Dr.
Martha Tracy. As we have said, there was nothing criti-
cally wrong with the Buxton formula. Many long-term
remissions were achieved with it.
But around this time, Coley became aware that Serra-
tia itself instead of being just a remarkable helper might
be a potent anticancer agent in its own right. In fact,
through experiments on animals, he began to suspect
that it was even more powerful than the strep itself.

Martha Tracy’s formula was designed to take advan-
tage of this new information on Serratia. In the Buxton
formula, no one could tell just how much Serratia was
actually present in the mixture.
But Serratia turned out to have an extremely variable
rate of growth. For this reason, unlike her predecessor
Buxton, Tracy grew the two microbes separately and
only mixed them together at the very end.
Tracy took a few cubic centimeters (ccs) of strep and
added these to small flasks of sterilized beef broth. She
allowed these to grow in an incubator for three weeks.
She then spread some Serratia on sterilized agar solu-
tion and allowed it to grow at room temperature in day-
light (but not direct sunlight) for ten days. She then
scraped off some of the thick red growth of the Serratia
with glass rods and ground these germs in a mortar and
pestle into a smooth and thick suspension.
She then mixed this with physiological saline (salt)
solution, bottled it and sterilized it at 75º C ( 167º F) for
one hour.

Tracy then used what are called ‘nitrogen determina-
tions’ to figure out how much Serratia was actually pre-
sent in the medicine. In this way she was able to achieve
"a definite standardization of dosage," wrote Coley.
All this was admirably precise. However, there was
and is also a rough-and-ready way to know whether or
not any given ampule contains much Serratia. That is
simply to observe its color. Serratia is "chromogenic,"
i.e., shows up as bright red in the vial. The redder the
solution, in fact, the greater the concentration of the
microbe. Reddish products, not surprisingly, were also
found to have greater anti-cancer effects.
Although Tracy could measure Serratia by measuring
the nitrogen content, initially she did not know just how
much Serratia to include in the final product. She
guessed—and guessed wrong.
"Very severe reactions were obtained by minute
doses," Coley reported in 1919, "and in one case, in the
hands of another physician, death resulted within a few
hours after an injection...into a very vascular tumor in
the mediastinal region."
The amount of Serratia was hurriedly reduced by half,
and then was used safely for decades. There were no
more deadly reactions.
But we see that this essentially non-toxic product
must be produced and administered correctly or serious
consequences can result.
While the Tracy product is admirably scientific, it is
also somewhat impractical to manufacture under less-
than-optimum conditions, e.g. in Third World countries.
And, for political reasons, it is most likely that Coley’s
toxins will be made and used in such countries for the
foreseeable future. While such countries do have labora-
tories that, with a small investment, can produce the tox-
ins, nitrogen determinations are trickier.
And since live microorganisms like Serratia cannot be
shipped across national borders, sending away for nitro-
gen determinations is also ruled out.
For that reason, under some circumstances, the
Buxton method is still used. The manufacturer has to
simply "eyeball" the pinkness of the final product to
judge its potency. This seems adequate.
However, before it can be injected into humans, each
batch has to be tested in animals.
Patients start their treatment with very small doses
to test the reaction. They then gradually increase the
dose, using the fever/chill reaction as a guide. The pro-
proper dose basically depends on the amount necessary
to raise the desired fever. I hesitate to talk too much
about dosage, because this is a medical question that
requires close attention to the individual patient. How-
ever, recent experience has been that the best way to get
people on the road to being clinically well is to give them
a great deal of vaccine. They will spell this out for you in
great detail.

This has led some clinics to adopt the following gen-
eral guidelines: they start with a minute amount .01 cc
(i.e., one-hundredth of a cubic centimeter) IM (intra-
muscularly). They increase this on each successive day
by 50 percent and in 13 days they level off at 1.00 cc (one
cubic centimeter). They then continue on 1.00 cc for a
total of four weeks. They then rest two (2) days and if
possible start IV (intravenous) injections at .01 cc
increasing this each day by 25 percent for a period of one
(1) week. On the following week they return to intra-
muscular injections (IMs), starting at .05 cc and continue
increasing this by 50 percent until they reach a MAXI-
MUM of 1.00 cc. After two weeks of IMs they return to
IVs if possible, starting at the same .01 cc, etc.
Again, this is an empirically derived formula, but is
not writ in stone. It is likely to be modified by further
clinical experience.

What if live bacteria are still lurking in the mixture?

Could this cause a blood infection (septicemia)?

In Coley’s day, the bacteria were usually heated to 58º
C (137º F) and no such problems were encountered. But
more recent experience has shown that even at 60º C
(140º F) some Serratia was still left alive in the mixture.
Therefore, today the product is generally heated to 65º C
(149º F) for two hours. The resulting product is strong
and has always proved sterile.

In Coley’s day, they also added a little bit of thymol, a
phenol preservative derived from the volatile oil of the
herb thyme. In recent years, some manufacturers have
used synthetic thymol for this purpose, while others
have used butyl alcohol.


Please turn to page 11

Somewhat more controversial is the fact that today’s
mixture tend to be filtered. This upsets some Coley
purists. Coley himself feared that filtering might weed
out some of the most desirable bacterial by-products.
However, in Coley’s day it didn’t much matter if a few
larger particles were included in the mix, since most
injections were either into a muscle (I.M.) or directly
into the tumor (I.T.) Intravenous injections (I.V.) were
not widely used in those early days.
For that reason, both heating and filtering was like
‘wearing belts and suspenders.’ However, today, if solid
particles were to be injected into a vein, this could
indeed cause serious adverse reactions, even shock.
(This is a largely theoretical concern; to our knowledge it
has not happened within living memory.)
It seems quite prudent, for this reason, to filter the
killed product through a five micron filter, as a precau-
tion against any stray particles. This should not affect
the potency of the mix, since the bacterial by-products
themselves are smaller than five microns.
Once this is done, the mixture is ready for use.

DIFFERENT PREPARATIONS

There were great differences in the results achieved
when different versions of Coley’s toxins were used.
While excellent results were often achieved with both
the Buxton and the Tracy preparations, there was also
an ineffective commercial preparation of the toxins
made at the Lister Institute of Preventive Medicine in
England, from about 1895 until 1944.
This is designated Lister VIII in the literature. (All
preparations were given Roman numerical designations
by Mrs. Nauts.)

Something was definitely wrong with the Lister
method of preparation. Even today it is painful to read
how British supporters of Dr. Coley repeatedly wrote to
him complaining about the weakness of these British
preparations. Injections of this product elicited no
fever/chill reactions and consequently proferred no clini-
cal benefit. They were essentially inert. But poor Coley,
without our modern means of communication, was
unable to remedy the situation.

Many of those writing to him had started out as enthu-
siasts, but became disillusioned or even opposed to its
development. It is perfectly understandable why skepti-
cism about this American innovation grew under the cir-
cumstances. It was based on such repeated stories of
failure that Sir Frederic Eve, a senior surgeon at Lon-
don Hospital, denigrated the use of Coley’s toxins in
print. Eve was highly regarded in the field and his article
in the prestigious journal, the Lancet, doomed the
treatment from receiving further serious consideration
in British medicine and consequently in many places
around the world.

In the United States, a similar situation prevailed
with the formula known as Parke-Davis IX. Although
the Parke-Davis company had started production with
the Buxton VI strain of strep, this strain had apparently
lost most (or even all) of its potency over time.
Nor did the company attempt to standardize Serratia
in the manner of Dr. Tracy.

Again, American colleagues wrote to Dr. Coley. What
they said was a giveaway that Parke-Davis was asleep at
the switch. For some of the bottles were reddish in color,
but others were perfectly clear, almost a sure sign that
there was little if any Serratia present in the mix.
This is one of the major reasons that there was a 58
percent five-year survival rate using Buxton formulas IV,
V and VI and a remarkable 67 percent using Tracy X and
XI. But there were zero cureswith Lister VIII or using
the later Sloan-Kettering XIV formula. (Sloan-Kettering
has never had much luck with alternative treatments of
any kind.) Everything depends ultimately on the inher-
ent power of the toxins. A weak or inactive preparation
will yield minimal, if any, results.

4 SITE OF INJECTION

In chemotherapy, oncologists often attempt to deliver
toxic drugs as close as possible to the site of the tumor.
The same principle applies to Coley therapy. By doing
this, one increases the ‘antigenicity’ of the tumor (i.e., its
visibility to the immune system), elicits an inflammation
reaction, and activates the macrophage cells, which are a
key element of the immune system.

In animal studies, the injection of immunological
agents such as BCG (bacillus Calmette-Guérin) directly
into a tumor produces a tumor suppressive response,
whereas little or no response is seen when it is given sys-
temically (Baldwin, RW. In: Steffin, C and Ludwig, H.,
eds. Clinical Immunology, Elsevier, 1981).
Initially, Coley himself injected the toxins into any
tumor that could be reached by a needle. In this way the
inflammatory reactions could be set to work. But Coley
suspended intratumoral injections in 1906, and did not
resume them until a year or two before his death. By
that time, he understood that he had made a tragic mis-
take in suspending them, and that by doing so he had
decreased the success rate of his treatment.
The reason he did this was to prove to skeptics that
the toxins exerted a systemic effect, and did not just act
by locally poisoning or eroding the tumor. This was an
important academic point, but should never have been
allowed to overshadow the therapeutic needs of the indi-
vidual patient.


DOSAGE, FREQUENCY AND DURATION

A sufficient amount of toxins must be given in order for
the patient to mount a proper immune reaction. But how
much is enough? Generally, as we have stated, the
patient should be given the dose that causes a strong
fever and/or chill reaction.
We have given one formula in use. But basically the
dose has to be established by trial and error, and it can
also be expected that a certain tolerance will develop.
One cautionary note, however, is that too small a dose
of Coley’s toxins, "given either intramuscularly or subcu-
taneously, may actually stimulate the target tumor cells
rather than inhibit them" (Nauts, HC. Breast Cancer;
1984, citing Prehn, RT, Science 1972;176:170-171).
Following the injection, especially intravenously, the
patient often experiences fever and chills for two hours
or more. Some doctors (and family members) may have
ambivalent feelings about allowing such reactions and
want to promptly reduce it. But through it all one must
always keep in mind that this unpleasant fever is the
main point of the treatment.
Historically, if the patient’s fever averaged 102º to
104º F or even reached as high as 105º F, and especially if
this was accompanied by chills, there was a 60 percent
chance of 5-year survival. This doesn’t even take into
account other factors that could increase these odds.
But when fevers averaged below 102º F, the survival
rate in otherwise comparable patients dropped to 28 per-
cent. And if there were few if any fevers, the 5-year
survival rate fell further to 20 percent.
Duration of treatment is another especially important
factor. In fact, it cannot be emphasized enough.
•When the toxins were given for just 1 week, there was
no survival advantage to the treatment.
•When they were given for 2 weeks, there was 14
percent 5-year survival.
•When treatment was continued for 2 months, there
was 42 percent 5-year survival.
•And when they were optimally delivered for 6 months,
80 percent of the patients survived 5 years or more.
Further treatment after that time did not increase
the survival rate, although a periodic booster shot was
considered desirable.
We can conclude that for optimum results the treat-
ment should be given for a minimum of five or even six
months.
Even many doctors who gave the treatment were
unaware of the need to give the treatment aggressively
at least three times per week initially.

6 TIMING IN RELATION TO SURGERY

Understandably, because it never was accepted as a con-
ventional treatment,Coley’s toxins were generally given
in far advanced, so-called "terminal" or "moribund"
cases. In such cases, although it still could possibly cure,
more frequently it palliated the condition.
It should be emphasized that Coley’s toxins do not
contradict the usefulness of adequate surgery. In fact, it
is particularly appropriate when used as an adjunct
before and after conservative surgery.
Mrs. Nauts points out that it is "particularly needed in
all postmenopausal women to augment their response to
adjuvant chemotherapy." It should be given during the
time when recurrences or metastases are most likely to
develop. It can be used to reduce the tumor burden and
to protect against the harmful effects of chemotherapy
and radiation "while potentiating the response of the
tumor to these modalities" (ibid.).

7 FEVERS AND CHILLS

Fever and chills are the hallmarks of this treatment.
They are certainly unpleasant, but are they bad for us?
According to the authoritative Merck Manual, "whether
to treat an elevated temperature that occurs with an
infectious disease is the subject of an ongoing debate.
Experimental evidence suggests that host defense
mechanisms are enhanced by an elevated temperature;
thus, fever is potentially beneficial and should not be rou-
tinely suppressed" (16th ed., 1992, p. 9).
In cancer, the existence of fever outside of Coley’s tox-
ins can be a serious complication. This is especially so
when the patient is suffering from immune suppression
following chemotherapy. We are not commenting here on
the wisdom of antibiotic therapy in such cases. We are
just trying to point out that there is a strong philosophi-
cal bias against not just allowing fevers but utilizing
them as a therapeutic procedure in any cases.

It bears repeating that patients who had fevers which
averaged between 102º and 105º F ( 39–40.5º C) had a
significantly higher percentage of complete and perma-
nent regressions. This was especially true in inoperable
or metastasized cases. In addition, the responses were
better when injections were given in or near the tumor;
intravenously, or in larger intramuscular doses. The sub-
cutaneous route was historically the least effective.
The largest number of "spontaneous remissions" also
followed infections in which there was a high fever.
But fevers are not easy to endure. If the fever goes on
beyond two hours it can be brought down within fifteen
minutes or so by Tylenol suppositories or other anti-
fever medications. (Since Tylenol can have side effects of
its own, it is optimal not to have to resort to such agents.)
Prescription muscle relaxants are also sometimes
used. Patients suffering from chills sometimes find warm
baths to be comforting. Those who are troubled by
headaches or other discomforts associated with the fever
might find some relief by taking an enema.

Some researchers believe that a coffee enema or two
per day while undergoing vigorous cancer treatment
decreases the amount of toxic buildup, and leads to an
improved feeling of well-being. But more should only be
undertaken while under medical supervision.
Fevers are still somewhat mysterious. We know that
infections, real or simulated, can trigger the release of
various chemicals called endogenous pyrogens in the
body. (Endogenous pyrogens are varieties of cytokines.)
Generally speaking, these are peptides or protein-like
materials produced by many and varied cells of the body.
The names of some of these pyrogens are interleukin-
or IL-1 and IL-6, tumor necrosis factor (TNF) and inter-
feron-alfa.

You will notice that some of these are themselves
being explored as cancer treatments. But they are usu-
ally tested as single agents in high doses. In Coley’s tox-
ins the patient gets them all in small to moderate
amounts, with many agents working together in concert
in a natural "symphony." Philosophically, Coley’s toxins
is worlds apart from the kind of immunotherapy now
promoted by the National Cancer Institute.
An increase in these cytokines can in turn stimulate
various important immune function cells including mono-
cyte-macrophages, keratinocytes, and endothelial, B,
epithelial and glial cells.

These cells in turn influence the heat-regulating cen-
ter of the hypothalamus, which is sometimes called a
"master gland" of the human body.

Macrophages (literally, "big eaters") themselves can
kill cancer cells, but must first be activated by other fac-
tors. And the most effective way of activating them is
simply to bring them into contact with "a variety of
microorganisms and their structural components"
(Heppner, GH and AM Fulton, Macrophages and Can-
cer, Boca Raton: CRC Press, 1988, p. 150).
Various high-tech and incredibly expensive ways have
been devised of doing this. In fact, the sale of purified
fractions makes up an increasing component in the
worldwide anticancer drug marketplace (see the author’s
Questioning Chemotherapy, p. 76).
Coley’s toxins, on the other hand, remains a relatively
easy, inexpensive and natural way of getting the body to
produce its own supply of these chemicals. It is natural
because it simulates something that happens or at least
used to happen on a regular basis in our species, i.e.,
severe bacterial infections.

(On a speculative note: I once knew a woman who
tragically refused all treatment for breast cancer. The
cancer predictably metastasized and killed her. How-
ever, before she died she developed an infection of the
suppurating ‘wound’ that had become her breast.

At this point, the breast became inflamed and while
she was bathing one day this primary tumor literally fell
out of her breast, leaving a clean hole. As stated, how-
ever, the woman died of the metastases, and so this form
of ‘treatment’ is certainly not recommended. However,
one has to wonder if in those endless stretches of time
before the development of modern cancer therapy,
tumors that broke to the surface of the skin and became
infected sometimes spontaneously healed with nature’s
own form of "Coley’s toxins.")

TOXICITY

The unfortunate appellation "toxins" has certainly has
done its share to scare people away from this treatment.
But all euphemistic names (such as "mixed bacterial vac-
cine") have never really stuck. And so Coley’s toxins it is.
Ironically, we have a right to ask whether Coley’s
toxins should really be considered a toxic form of cancer
treatment. The answer depends on what one means by
"toxic."

The goal of Coley’s treatment is clearly to stimulate an
intense immune reaction, such as one normally experi-
ences when assailed by an intense bacterial infection.
Fever, chills, sweats, or even headaches are very
unpleasant, and in that sense one must acknowledge that
this is certainly not a treatment without its drawbacks.
Plus, Coley was aiming for the maximum therapeutic
effect and to get this he sought out the most "toxic"
strains of microbes he could find. As he once said, "I
obtained cultures from fatal cases of erysipelas in order
to get the highest degree of virulence." The strep he pre-
ferred (from the Huntington Cancer Research Fund)
was isolated from a fatal case of septicemia. "It is doubt-
ful whether an organism from an actual case of
erysipelas would give any better results," he wrote,
enthusiastically.

However, the word "toxic" has changed its meaning in
the intervening decades. Chemotherapy has added a
whole new dimension of toxicity to the medical text-
books. Chemotherapy destroys a great many of the nor-
mal cells of the body, especially those of the immune
system. Although oncologists routinely deprecate any
concerns over this aspect of the treatment, it seems clear
that attempts to resort to immunological treatments
after chemotherapy are greatly hampered. To what
degree the immune system really recovers from inten-
sive chemotherapy (or radiotherapy) is uncertain.
By contrast, to our knowledge, Coley’s toxins leave
the various organ systems and tissues of the body in as
good if not better shape at the end of the treatment than
they were at the beginning. This seems particularly true
of the immune system, which seems to be toned and
enhanced by the treatment. As Mrs. Nauts summarizes:


The available evidence suggests that
Coley’s toxins are without harmful or dangerous
effects to patients or animals suffering from
various types of neoplasms, provided these toxins
are administered properly as to dosage, site and
the usual aseptic precautions."
She does emphasize the following limitations on the
treatment, however, which should be understood by all
those considering this route:
" They should not be given to patients with severe
hepatic [liver] insufficiency due to metastatic disease or
other pathology, nor to patients who have had severe
heart conditions, nor to patients who are almost mori-
bund, because such patients do not respond."
Any questions on the potential danger of the treat-
ment must be referred to a competent medical doctor.

BARRIERS TO ACCEPTANCE

The history of Coley’s toxins presents some unusual fea-
tures to students of alternative medicine. Oftentimes,
proponents of unconventional treatments are them-
selves "outsiders." Some are not cancer specialists or not
even medical doctors. Their treatments may be mar-
keted in various "underground" or even illegal ways.
This guarantees that they are dismissed or attacked as
arrant quackery by the regular medical profession. And
no doubt some of them are classical quackery, with tragic
consequences.

Under conditions in which alternatives are routinely
dismissed as worthless, practitioners have little incen-
tive or even possibility of documenting results with such
treatments, much less long-term outcomes.
What makes Coley’s toxins stand out, however, are
that Dr. Coley was the very opposite of a "quack." He
was a highly regarded surgeon at one of the world’s fore-
most cancer centers, with scores of scientific publications
to his credit. He never attempted to go over the heads of
his medical colleagues and directly address the public
with either his claims or his frustrations. (He developed
ulcers instead.) In that bygone era, he and his collabora-
tors were highly honored for their work. In fact, no finer
group of doctors could have been found at that time.
And far from exploiting his treatment for financial
gain, Coley was exceptionally generous towards all
patients. In 1897, in fact, he established the Needy
Patient Fund at Memorial Hospital. In 1898, records
show that he handled some 40 of these charity patients
himself and often paid their bills out of his own pocket.
Indigent cancer patients were referred to him from all
over the United States and he never refused to treat
them. In fact, Coley himself performed up to 60 percent
of the "free" operations at Memorial Hospital between
1908 and 1913 (Nauts, HC. Coley’s Toxins: 1893-1995 and
Beyond. Speech to Pharmacia, Lund, Sweden, 5/15/95).
He did not attempt to patent or otherwise monopolize
the treatment, and in fact spent a great deal of his own
money sharing his knowledge with scientists around the
world. There were no secrets, other than those that
Nature has kept from the scientific community.
Alternative cancer practitioners are also often
accused of disregarding the long-term outcomes of their
cases. Dr. Coley kept good records, and made it possible
for his intrepid daughter to compile the outcome of 896
cases who had been treated by either Coley himself, his
son, Bradley, or their worldwide collaborators. This
work was meticulously carried out by Mrs. Nauts.
Cancer alternatives are also often characterized as
inordinately expensive. But the cost of Coley’s toxins has
always been remarkably low, in fact just pennies a day
for the medicine. They are simple to produce and may be
ideally suited for very poor countries. (In fact, there is a
Coley’s hospital in China.)
The starting broth, which today is generally a syn-
thetic mixture called AOAC Depco, costs around $10.00
and takes about 30 minutes to assemble.
This is then put in the incubator, where it is inoculated
with the strep organism. The laboratory technician then
goes away and comes back in ten days. A second inocula-
tion is then done and he or she then goes away again for
another ten days. The total labor time comes to about
five hours, and this work produces about a quart (1,000
ccs) for a total cost of about $100. Mass produced they
might cost even less.
Naturally, the patients’ cost will be considerably more
than this. There has to be some markup for the people
producing the toxins, for the doctors and hospitals that
administer the treatment, etc.
But, still, this is a potentially inexpensive "drug."
Ironically, this makes it very unattractive to those in
power in the medical field. It has long been our con-
tention that Coley’s toxins cannot compete in the drug
marketplace dominated by patented chemotherapeutic
agents. They are just too cheap.
SOME COMMENTS ON THE MICROBES
In general, the micro-organisms themselves are easy to
come by. Various biological supply companies sell live
cultures for research purposes for very little money.
Clinicians have been known to obtain potent Streptococ-
cus from the "strep throat" of their patients. In some
places they are available from medical schools. They stay
alive for a long time and usually do not lose their potency.
Streptococcus pyogenes is a Gram-positive, nonmotile
round to egg-shaped coccus which occurs in either pairs
or chains. Most Streptococci are anaerobes, i.e. flourish in
the absence of air. They are generally encoated in a cap-
sule made up of hyaluronic acid.

Although Streptococci are part of the normal flora of
the nose and mouth (we all probably have some resident
in such places), under certain circumstances they can
cause a variety of human diseases. These include pneu-
monia, scarlet fever, rheumatic heart disease, and
glomulonephritis. Acute strep infections can take the
form of pharyngitis, scarlet fever (rash), impetigo, cel-
lulitis, and of course, more to the point, erysipelas.
Various factors can affect the ability of this microbe to
cause disease. The immune system normally produces
antibodies against what are called "group A" Streptococ-
cus, which is the type that is commonly associated with
human illness. Also, we know that gamma globulin (IgG)
is produced by the mother in her milk to protect babies.

PLEOMORPHISM

Students of alternative treatments will be interested to
know strep infections (and thus, Coley’s toxins) may
interdigitate with certain bacterial theories of cancer’s
origins. Even orthodox textbooks point to the existence
of certain forms of strep that resemble those weird pleo-
morphic organisms seen by innovative researchers such
as Gaston Naessens and Virginia Livingston-Wheeler.
According to the recent edition of a classic textbook:
"Recently, nutritionally deficient streptococci (also
known as [cell] wall-deficient, L form, etc.) have been
recovered from a variety of clinical sources....These vari-
ants demonstrate bizarre pleomorphism microscopi-
cally...." (Baron, Medical Microbiology, 4th Ed, p. 202).
Strep also contains various substances which can
prompt an immune response. These include peptido-
glycan in the cell wall, pili M protein type antigen; lipo-
teichoic acid; and R and T proteins.
In addition, strep produces a wide array of products.
These include the following: streptolysins, NADase,
hyaluronidase, streptokinase, streptodornases, and
pyrogenic exotoxins (the main source of fevers). These
have been studied intensively, yet scientists are still not
clear how or why strep causes disease (Baron, p. 204).
Streptokinase in particular has independent anti-
cancer properties, although it may be destroyed when
the Coley’s product is heated.

SERRATIA MARCESCENS

Serratia marcescens is a Gram-negative bacillus that is
normally found in the human intestines. In this regard it
is similar to the E. Coli bacteria found in the gut. They
are both called coliform bacteria (no relation to Dr. Coley).
Marcescens is one of 11 species of the Serratia genus.
At one time it was dismissed as a harmless part of the
intestinal flora. It was Coley who first pointed out its
important biological (even curative) role, although this
was not accepted in his own day.

Today, it is finally acknowledged to be one of the six
or seven bacteria that is responsible for most infections
produced by this group. It is particularly found as a cause
of pneumonia and of urinary tract infections following
catheterization as well as infections complicating burns.
What do these microbes do in the body that could have
such an effect on cancer? Serratia contains various mark-
ers on its surface, called H, K. and O antigens.
H antigens are derived from the numerous "tails" or
flagella that stick out from many places on the microbe’s
cell surface. Some Serratia have K or capsule antigens,
which are components of the polysaccharide capsule that
surrounds the cell.
The outer membrane of the bacteria contain
lipopolysaccharide (LPS), of which the lipid portion is
particularly toxic. It was in the course of experiments
with LPS (and a tuberculosis vaccine) that the anti-
cancer substance, tumor necrosis factor (TNF) was
discovered at Sloan-Kettering Institute in 1975.
If we don’t really know which of these creates the
anticancer effects do not be surprised. In fact, the pro-
cess by which Serratia produces disease is itself still
poorly understood. In fact, it rarely does cause disease
unless the host defense system fails in some way.
Humans with systemic infections from Serratia do dis-
play the common effects of bacterial toxins, which
includes fever and chills.
These bacteria are normal to the host, and in fact gen-
erally keep each other in balance. The reason that Serra-
tia marcescens is now often infectious (but was formerly
rarely so) has to do with the fact that Serratia
marcescens is frequently found in hospital-acquired
(nosocomial) infections as well as community-acquired
human diseases.

CONCLUSIONS

We have now had 25 years of the ‘war on cancer.’
Although Congress was promised a cure in time for the
Bicentennial, there was been little progress towards that
goal. It appears that chemotherapy has about reached
the limit of its usefulness.
Coley’s toxins (and related treatments) represent a
different way of approaching the cancer problem. Admit-
tedly, this is a difficult treatment for the patient, since
fevers and chills are decidedly unpleasant. However,
despite the name, Coley’s toxins are far less toxic than
conventional chemotherapy.

The historical record documents the frequent suc-
cesses seen with this method. It thus is absolutely imper-
ative that Coley’s work be revived, reproduced, and
extended. "Improvements" on this work should only be
embraced when it can be demonstrated that they yield a
higher five-year survival rate than the original method.
In this way, we can reach into the past to find a viable
treatment for the future. M

Editor in Chief: Ralph W. Moss, PhD
Managing Editor: Martha Bunim
Associate Editor: Melissa Wolf
Contributors Anne Beattie
Advisors: Peter Barry Chowka
Jane Heimlich
Robert G. Houston

The Cancer Chronicles is an independent periodical, published
and distributed exclusively by Equinox Press, 144 St. John’s Place,
Brooklyn, NY 11217. (718) 636-1679; Fax: (718) 636-0186.
We publish the equivalent of six eight-page issues per year for
general educational purposes only. It is not an advocate of any
treatment modality, nor does the editor or staff have any financial
connection to the treatments, practitioners, or sources written
about. Each reader is strongly urged to consult qualified
professional help for medical problems.

For further information on Coley’s Toxins:

See Ralph W. Moss, Ph.D., The Cancer Industry, Equinox
Press, Brooklyn, New York, 1996, chapter 7. See also the
same author’s Cancer Therapy, Equinox Press, Brooklyn,
New York, 1995, pp. 407-413, as well as related chapters
on MTH-68, Maruyama Vaccine, etc. To order these
books, one can call the publisher at 1-718-636-1679.
Ralph W. Moss, Ph.D. is the author of eight books and
three documentaries on cancer-related topics. He is an
advisor on alternative cancer treatments to the National
Institutes of Health, Columbia University, and the Uni-
versity of Texas.
He researches and writes individualized "Healing
Choices" reports for people with cancer. For information
on Healing Choices, you can contact coordinator Anne
Beattie in the following ways:
HEALING CHOICES REPORT SERVICE
Coordinator Anne Beattie
Address 144 St. John’s Place, Brooklyn, NY 11217
Phone 718-636-4433
Fax 718-636-0186
E-mail equinox@walrus.com
Web site http: / /www.walrus.com/~equinox/



ISSN: 1044-6508
The Cancer Chronicles
SERIOUS CONSIDERATION OF ALTERNATIVE IDEAS
VOLUME 7, NUMBER 3-4 (#34-#35) EDITED BY RALPH W. MOSS, PH.D. SEPTEMBER 1996
SPECIAL
DOUBLE ISSUE:
Treating Cancer
with Microbial
Products
v Coley’s
Toxins
v MTH-68:
Newcastle
Disease
Virus Vaccine

EDITORIAL - CANCER AND MICROBES

This issue deals in a detailed way with two
treatments, Coley’s toxins and MTH-68. One of
them uses bacterial, the other viral, products
as a treatment for cancer. Both rely on natural
reactions of the immune system to fight the
disease. Both have been tragically neglected.
The whole topic of micro-organisms and
cancer is due for serious reconsideration. The
current vogue for genetic manipulation is
bound to run its course. People will once again
be demanding a new therapeutic idea, and one
that works.

The rise of AIDS, as well as antibiotic-
resistant superinfections, has stirred the
popular imagination. This interest is bound to
eventually spill over into cancer research.
When scientists get around to exploring the
relationship of cancer to microbes they will
find that they have ample predecessors. In
the 18th century, cancer was considered a
contagious disease. But even after this idea
was discredited, fruitful work was done on
cancer and parasites or lower organisms.
This whole topic has been fraught with
false alarms. For every scientist who claimed
to find a particular micro-organism causing
cancer, there have been a dozen arguing that
the organism in question was not the cause
but a mere "hitchhiker" or contaminant.
But theories of microbes and cancer persist.
Most "spontaneous remissions" occur after
some infectious process. And some of the
most exciting treatments of today attempt
to reproduce those "experiments of nature"
in the clinic or to vaccinate against putative
cancer-causing microbes.

In this special issue we present a detailed
discussion of two such treatments. We hope it
will contribute towards a more serious consid-
eration of the many links between cancer and
the microbial world.