Surviving Against All Odds: Analysis of 6 Case Studies of Patients With Cancer Who Followed the Gerson Therapy A. Molassiotis and P. Peat The Gerson therapy is a nutritional approach that allegedly has anticancer effects. It was developed by Max Gerson in the 1920s as a metabolic therapy that claims to cure a number of chronic and degenerative diseases by detoxifying the body and boosting the immune system.1,2 This dietary regimen is based broadly on detoxifying the body with coffee enemas, a diet based on organic fruits and vegetables, a large amount of freshly made juices, and supplementation with several enzymes or natural medication (ie, niacin, acidol pepsin, Lugol’s solution [iodine], pancreatin, potassium, co-enzyme Q10, and/or thyroid extract), as seen in Table 1.3,4 Since Gerson published his book in 1958 (now in its third edition) detailing the “cure” of patients with advanced cancer,5 the medical community has been highly skeptical and sharply hostile toward this nutritional therapy. There is consistently strong criticism of it in the medical literature, and attempts to assess the effect of this regimen have failed to identify any benefit, with some of the reasons behind this including negative medical attitudes, unavailability of funding, limited availability of appropriate patient data, and lack of follow-up in treated patients. The American Cancer Society and the US National Cancer Institute (NCI) do not recommend the use of Gerson therapy, warning that patients should not turn away from mainstream therapy. Besides the (potentially biased) publication of successful treatments in the book by Gerson5 and a summary of the experience of the therapy published in the 1970s,6 there is only 1 report in the international medical literature that has attempted to show some positive results in a more coherent and scientifically appropriate manner.7 The latter report was a retrospective review of 153 patients with malignant melanoma, comparing their 5-year survival rates with those of published reports of patients receiving conventional treatments. The authors showed that the survival rates of patients using the Gerson therapy were significantly higher than rates published in the literature for stage II melanoma (100% vs 79%), stage IIIa (82% vs 39%), stage IIIa and IIIb (70% vs 41%), and stage IV(a) (39% vs 6%).7 This is the only peer reviewed publication showing positive results using the Gerson regimen in the medical literature. Another case series report summarizing the 6-year experience of using a drastically modified type of the Gerson therapy in an Austrian medical center was published in 1990, which provided strong clinical impressions of the effectiveness of this regimen.8 The authors presented findings from 18 matched pairs of cancer patients (gastrointestinal and breast cancer were the 2 most common diagnoses) who underwent surgery with adjuvant modified Gerson therapy or surgery Table 1. Overview of the Gerson Regimen Included in Gerson Regimena Coffee and/or castor oil enemas Vegetable juice, 13 glasses/d or more (ie, carrot juice); juices must be pressed Only organic fruits and vegetables Tablespoons of linseed oil Acidophilus-pepsin capsules; drops of Lugol’s solution; niacin; pancreatic enzymes Thyroid tablets Rectal/oral hydrogen peroxide Rectal ozone therapies Megadoses of vitamin C for severe pain a.Treatment is individualized, and different enzymes may be used in varied quantity based on the patient’s needs. Not Allowed::Aluminum utensils, Salt, Oil, Coffee, Drinking water, Animal protein, Bottled, canned, refined, preserved, or frozen food, Berries or nuts and continuation of usual lifestyle. While the clinical details of the cases are briefly presented, the authors reported with regard to the Gerson therapy group impressive survival improvements (28.6 vs 16.2 months), prevention or at least delay in the onset of cancer cachexia, fewer postoperative complications, less marked side effects from the chemoradiotherapy (it is not clearly reported how many patients received either chemotherapy, radiotherapy, or both), use of lower doses of analgesics, slower progression of existing liver metastasis, and a lower occurrence of malignant effusions.8 On the other hand, reports based on a review of records demonstrating a lack of evidence of any beneficial effect have also been published2,9; mostly due to lack of biopsy confirmation of the cancer diagnosis and are limited in terms of follow-up processes. However, despite the strong medical opposition to this therapy, many patients have used and are using it for managing their often advanced cancer. This can either be a public health issue if proven to be an inappropriate intervention or an added choice for patients if proven to be helpful. Thus, more concrete answers in scientifically rigorous and appropriate methods are necessary. The aim of the current study was to critically review data from patients with cancer who used the Gerson therapy and provide some scientifically interpretable information about its potential effect in an attempt to reignite the debate and contribute to a balanced discussion on the appropriateness of such a nutritional approach to cancer treatment. Methods This study was a record review based on the Best Case Series approach as described by the NCI (http://www .cancer.gov/cam/bestcase_intro.html, and personal communication). The case studies were selected for the completeness of their data in terms of documented pathological diagnosis of cancer, documented use of the alternative therapy, documented tumor regression appropriate for the disease type and location, and absence of confounding and/or concurrent anticancer therapies. Cases meeting all the above criteria are persuasive cases (of which at least 2 are needed), but cases that do not meet all of the above criteria (ie, with some confounding factors) can still be reviewed as supportive cases. A case study design can be capable of providing valuable insight into an alternative therapy and can generate useful preliminary conclusions and research questions.10 The current study is based on a review of 6 cases, with some patients being involved in the study as coresearchers. All case studies were derived from the UK-based Gerson Support Group, which has as its members a considerable number of cancer patients who have used the Gerson regimen successfully. This is a small national patient group that is supporting patients who are considering the use of or are using the Gerson regimen through information, advice, education, and material support. We have used the medical records of patients for conducting this review but have also clarified points during short interviews with patients. The research question and the subsequent review have been prompted by the patients themselves, who wanted to explore the effects of this intervention in a more rigorous way and contribute to the development of the research agenda around alternative therapies. All patients (and the main caregiver of the deceased person) have received information about the case study by letter, and they all signed a consent form giving permission to the researchers to obtain a copy of their medical records and use that information for the case study. Confidentiality and anonymity were maintained. The review process was approved by the Ethics Committee of the University of Manchester, United Kingdom. The complete records of each patient were reviewed by the 2 researchers independently, following the case report format of the NCI Best Case Series program. Scans and slides had been previously reviewed by pathologists and/or radiologists— in most cases by more than 1 specialist—and hence the current review is based on their reports. In addition, all summaries of the evidence were submitted and reviewed by clinical oncologists (n = 4) who made comments on the clinical progress of the cases relevant to their specialty and suggested possible clinical explanations for the recovery observed in some of the cases. Their comments are incorporated in the discussion of this study. Integr Cancer Ther 2007; 6; 80 DOI: 10.1177/1534735406298258 Gerson Case Study 1 Integr Cancer Therapies, 3/07 Gerson Case Study 2 Integrated Cancer Therapies, March 2007 Case Study 3 Integr Cancer Ther 2007; 6; 80 Case study 4 Integr Cancer Ther 2007; 6; 80, March 2007 Case study 5 Integr Cancer Ther 2007; 6; 80, March 2007 Case study 6 Integr Cancer Ther 2007; 6; 80, March 2007 Discussion on Gerson Therapy and 6 Case Studies Integr Cancer Ther 2007; 6; 80, March 2007 References for Gerson Case Studies Integrated Cancer Therapies, March 2007 Remember we are NOT Doctors and have NO medical training. This site is like an Encylopedia - there are many pages, many links on many topics. Support our work with any size DONATION - see left side of any page - for how to donate. You can help raise awareness of CAM.