A Talk by Dr. Donald Cole at the Annual Cancer/Nutrition Convention of FACT on May 29, 1979
Ruth Sackman: I’d like to introduce you to our next speaker, Dr. Donald Cole. He is associated with several New York City Hospitals, is Director of the Wholistic Health Center in Floral Park and Director of Oncology and Surgery at the American International Hospital Clinic in Zion, Illinois. He is also a chemotherapist, surgeon, oncologist and heat therapist. We subscribe to the heat therapy only.
Dr. Donald Cole: As Ruth mentioned to you, the heat therapy is actually whole-body hyperthermia. I think it would be of some interest to you as to why we became involved with that, because as oncologists and chemotherapists, etc., why should we be interested in heat. I think the problem of statistics will show how we came to this field and why we think it is a very valuable adjunct to the whole cancer scene.
Cancer of the breast is thought to be, among most oncologists, surgeons and others in the medical profession, one of the easiest types of cancer to treat; that is, in terms of the way it can be handled. Certainly, it is one of the most frequent forms of cancer. And it seems to be on the rise. We think perhaps that the reason we do so well is that it’s detected earlier and also because the American Cancer Society and other organizations produce voluminous information on self-examination, mammography and other techniques. The final figures are very interesting. Fifteen percent of women, according to the hardest statistics, who develop cancer of the breasts will do as well if they have no treatment at all.
If a woman develops a lump in the breast; should she have mammography? There is a great deal of evidence that would indicate that she should, and there is a great deal of evidence that mammography contributes to the development of cancer. When a woman is told that a tumor has developed in her breast, she can go to any center she wishes and get one of about four different opinions all different, and all at large, respectable centers. She could have the lump removed and a diagnosis made of cancer, let’s say. Then, perhaps, have no treatment, or, at another center, have X-ray therapy, or at still another center have a radical mastectomy, or at another place have a modified radical, or at another place have a super radical, or at another place have the opposite, breast biopsy. Very interesting. Now, at certain centers they will say she should have chemotherapy. If she has conventional, traditional, acceptable the best chemotherapy her life expectancy from the time that chemotherapy starts is ten and a half months. We are not talking about cures.
Now once chemotherapy starts, then the question comes up; “What about the quality of these ten and a half months, and how long would she last if she didn’t have it?” Now if she had positive nodes, no matter what we do, her chances for a five-year survival, under the best circumstances, is about 30%, and of course they continue to diminish after five years.
If she has negative nodes after five years, she has a 7075% chance of surviving, and then this diminishes as time goes on. If she has X-ray therapy, there is no improvement in the survival rate at all. In fact, one wonders whether the quality of life is as good with the X-ray treatment, in addition to primary treatment.
At many centers, X-ray treatment is now really being abandoned after breast removal for cancer. So you can see that if this is the best we can do, it is really a far cry from what we would like to do and certainly what the patient should like to have done.
I don’t have to tell you that removal of the breast is a mutilating procedure for most women and they find it hard to cope with. I think it’s a constant fear in women that, some day, they may have to face it.
The ideal part of this treatment to me, on a theoretical basis, is that it answers two of the deficiencies in most cancer therapies. One, it is not mutilating, and it is nontoxic. Secondly, you are treating cancer as though it is a disease of the body.
If you take the statistics today on the average patient population with cancer of the breast and compare it with twenty years ago, there is no improvement in terms of how many women will live and how many will die, how they will die, etc. None whatever. Now, I want to remind you why I started out by saying we think that we can do the best in this situation. If we start to talk about conventional treatment for cancer of the lung, esophagus, pancreas, and on and on, the results are nowhere near as good as with breast cancer.
Now many of you may ask, or you should ask, “Why is this true?” I’ve heard that Ga be Pressman in the recent TV shows that he has had on Channel 5 on “WHAT’S NEW IN CANCER,” asked the question initially, “How come in twenty years the cure rate has increased 2% at the expenditure of, I think, 42 billion dollars?” No one has the real answer of why, but we feel the answer lies somewhere in the following fact: that cancer is not a local disease.
In fact, what I just heard Dr. Watts say, and consequently, if we direct our attention to a local problem, when the problem is really a generalized problem, obviously this might explain one of the problems in the cure rate, or survival rate. In addition, we, as surgeons, always feel that the best thing is to remove the cancer. If you have a tumor, get rid of it; if you have a cyst, get rid of it. I’d like to add that I believe this is correct. As time went on and surgical procedures could become more extensive with improvement in anesthesia and nursing care, it certainly appeared that the best thing to do was to remove more; and if you removed more, then you had a better chance of removing all of the primary cancer which is certainly not visible to the surgeon.
And yet, no matter how much we removed, the patient still went on and died of cancer. In fact, one of the attitudes in our clinic was that if the surgical procedure, by its very nature, had to be mutilating in terms of what the surgeon had to do to remove all of the tumor, in his best estimation, that’s already a sign that it is going to be a failure.
No matter how much you remove, the patient would still go on to die, because cancer had spread beyond his knife: because it had gone into his bloodstream, and would be deposited accordingly. So with surgery not answering the problem, X-ray therapy was added, and X-ray therapy of course increased the local field of destruction, but didn’t solve the basic problem.
In fact, the complications from the additional X-ray therapy adds one other dimension since it is a very destructive force to normal tissues as well as abnormal tissues. Consequently, many complications come about, just from the additional X-ray therapy.
In addition, when given in certain areas, you may damage the bone marrow which is the main source of the immune response. So when these things didn’t work, chemotherapy came on the scene and what we thought (I thought so too) was the answer to the problem. But, you see, there is no chemotherapy drug which is specific for cancer. Chemotherapy drug, when it works, is specific for living cells. In many situations, naturally, it will go to the normal cell and destroy that without ever affecting the abnormal cell because we can’t pick out which cell it will effect. So, we decided the best way was to give as much of these poisonous drugs as the body could sustain, and theoretically when the body started to react with what we call toxicity, or side-effects, that meant you could go no further, or you might kill your patient. But, hopefully, you would not have destroyed too many normal cells but all of the abnormal cells. But it doesn’t work that way. Many times we can destroy the normal cells without affecting the abnormal cells at all. And to make matters worse, the effect of these destructive agents, just like X-ray therapy, is to go to the bone marrow, and affect again the source of the immune response.
In order to do a successful transplant, a bone marrow transplant, a renal transplant, you name it you must first destroy the immune system in the patient, because if you don’t they will reject the transplanted organ and destroy it; and what we do to destroy the immune system for the transplants is to usecancer chemotherapy drugs. So, we destroy the immune response to allow the patient, not a cancer patient, to have an organ transplant. In fact, I heard just recently that a patient was brought in for a renal transplant, they destroyed her immune system and in doing it (over a two-week period), she suddenly developed pulmonary nodules evidence of metastasis, or put in another way, she had cancer that was not detectable. She was having a renal transplant for a different reason, and her own immune response had apparently been successful in sustaining the cancer. So it had not been evidenced clinically, but when the immune system was destroyed, she died of metastatic cancer. The incidence of cancer in patients, incidentally, who have had transplants, who have had destruction to their immune system, is greater than in the overall population, as one would expect.
We are taught, as oncologists, that today probably all of us get cancer or have cancer all the time, or are exposed to cancer, or it is in our body incidentally. I am sure that’s true. So what is amazing is that we can do as well as we do in certain cancers like Hodgkins, leukemia, in terms of getting any remissions, because in order to get a remission we have to use high doses of drugs which will destroy the immune system and yet we do get a remission; but that’s why we don’t usually get a cure.
Now with these things in minds, and certainly at Ruth’s insistence, and because of our own frustrations, we decided to listen to someone who wasn’t an oncologist or an M.D., which of course, is a disgrace to admit. She told us about the work of Dr. Pettigrew in Scotland and then Dr. Larkin in this country. It certainly was fascinating and we decided to look into it and came up with a lot of interesting facts. First, that there is no question that heat can destroy cancer cells and for a variety or reasons I can think of, a lot of logical reasons but we really don’t know for sure, it doesn’t destroy the normal cells at the time it destroys the abnormal cells.
This has been proven at the National Cancer Institute and at various institutions. It has been proven in tissue cultures, and also in living animals and humans. In fact, the Japanese, this past year, at their cancer research institute demonstrated that an elevation of the temperature in cells could affect the cancer versus the normal; and at what levels the cancer cell would be destroyed. They demonstrated this at approximately 40 degrees centigrade where the cancer cell would be destroyed (about 75% would be destroyed) and the normal cells not affected. They went up another degree and it was close to 90% destroyed. And another degree; it was close to 100% destroyed. As they went over 40 degrees, the normal cell metabolism was starting to slow down but it was not destroyed. In other words, we are talking in the neighborhood of 106 to 107.5 degrees Fahrenheit. So when you hit the top level of about 107.5, the cancer cells were all destroyed, the normal cells’ metabolism had been slowed down considerably, but were not destroyed.
We think this may be related to the fact that the cancer cell is an avaricious cell and metabolizes at a very rapid rate to start with. I guess you can just push this so far and it explodes – it can’t handle it. Now, there has been a lot of work that demonstrates the effect of fever in disease. In fact, recently there was some work done in Georgia in which they demonstrated in animals with pneumonia or a pneumonia-like process, the animals that had fever with no treatment of the fever, provided it didn’t go to dangerous levels (which would be like over 104 degrees) did better than those that had their fever treated with antibiotics or with aspirin-like compounds, where the fever would be reduced. They didn’t recover as fast from their infection – put another way – that the fever we feel in a living being is a method of treatment of disease rather than just a sign of the disease. Now, Dr. Coley, in his work with the Coley toxin, which is really another form of fever therapy, had remissions. There are many cases on record of patients with terminal cancer of the lung who developed abcess or septecemia, and if they survived, a certain percentage would go into remission. Obviously, the fever had done something to the cancer.
Now, in whole body hyperthermia, what we are talking about is elevating the temperature to 107108 degrees Fahrenheit range, and hopefully the temperature of the tumor to this range. There are two forms of hyperthermia in general. There is the local hyperthermia in which a machine has been built using microwave, where they can locally increase the temperature of the tumor and they can put a thermometer into the tumor to indicate the elevation and also the destruction of the tumor and theoretically only the tumor will be affected by the heat but no other part of the body. But this violates two principles, we feel. First, the microwave is a destructive force which can and does destroy all the tissues in the neighborhood where you are pushing it through, and secondly, again what we are really doing is trying to remove the local tumor; or put it another way, we are using another form of X-ray therapy. So, if you destroy the tumor, like you can with an X-ray beam with a lot of patients, most cancer patients will go on to die of their cancer and, likewise, they will after local hyperthermia.
The other system is called whole-body hyperthermia or systemic thermotherapy, which is really elevating the temperature of the entire body. We call it the core temperature which is what we are interested in the temperature within the rectum and the esophagus. The temperature which is produced externally has to penetrate through all the tissues in order to get to the core.
There are several ways to produce this heat. We think the best way is a method that we are using, which is using water-filled blankets that the patient is wrapped in. And these water-filled rubber blankets are attached to a machine which can push this heat to 140∞ or higher, or it can cool it right down through an air conditioning unit if it becomes necessary. It must be done under some form of light anesthesia because the temperature is intolerable if the patient is awake. The anesthesia we use is the lightest we can use. It is called a nonsurgical plane. In other words, the patient cannot have any form of surgery with this form of anesthesia, because it would be too light; they would be awake and would feel the pain.
We now have a hyperthermia room with several machines with all sorts of monitoring devices in order to check the patient’s responses of their vital organs, their liver, kidney, heart and lungs. All of this is monitored to be certain of what is going on because obviously this is a stress situation. We are using it in all forms of cancer but with certain requirements – mainly that the patient is cleared medically just as they would be for a surgical procedure. The patient requirements we feel, in order to make the procedure perfectly safe, revolve mostly around the heart, the lungs and the brain.
If the patient has had a recent heart problem, or if the patient’s ability to handle oxygen is 50% or less than normal, we would not go ahead with the procedure, because with the speed-up of the metabolism, the pulse rate goes up, the heart rate goes up, and breathing goes up and they have to be able to handle this safely.
We have now done about 220 procedures in some 190 patients. We have not done enough of any specific category except breast and lymphoma to really talk to you in terms of any valid statistics, but the National Cancer Institute and Dr. Pettigrew and others have done enough of the sarcoma group to state that this is a group that does respond quite well to the treatment. I might add that this is a form of cancer that usually does not respond to anything. If the patient is a good risk, in our opinion, for this procedure, the chances of their responding to hyperthermia in cancer of the breast are in the neighborhood of 60 to 65%. Now I am talking about patients who have had everything before they had hyperthermia. That’s a very high figure. Mind you, if a lady comes in with a lump in her breast and is stricken with cancer and it is removed with the best procedure you have available, and her nodes are negative, her chances of surviving 5 years are in the neighborhood of 75%. We are talking about the failures of that procedure and everything else.
In the lymphoma group, actually, at this point, our statistics are even better. We have only done about 15 of them. To give you valid statistics in other areas where we have only done one or two is meaningless. Because if you have got a success with only one, it is 100% but it really does not mean anything in terms of the overall statistics, but we do know enough about it to feel that it is a very worthwhile technique (that is, whole-body hyperthermia) in the treatment of cancer. Naturally, we would like to use it right from the beginning, but medically-legally we always have to tell the patient that they had to have every other available, so-called worthwhile technique prior to the hyperthermia or refuse it. And certain of our patients have refused anything further in the so-called conventional areas. I say that with tongue in cheek because when we first started using hyperthermia, most of our colleagues felt it was almost like witchcraft. However, I was pleased to hear recently that the new president of the American Cancer Society mentioned hyperthermia as one of the newest and sophisticated available tools in the treatment of advanced cancer.
There are several programs now going on in this country, and other countries. Recently, some of the third party insurance carriers have reimbursed patients for this procedure.
We think that our results justify this as a method of treatment of advanced cancer. We recommend this procedure be done a minimum of three times. However, many patients who have responded after one or two times will refuse a third treatment. There is no magic in the number three. It’s just that Dr. Pettigrew had developed a technique this way, and the National Cancer Institute (Larkin and others), have utilized three as a minimum, and that’s why, I guess, we jumped on the bandwagon, figuring that many treatments would be better than few, but I guess it is not necessarily true that you do it several times.
I might say that Pettigrew has done it 26 times on one patient over a several year period when the tumor started to come back. The ideal part of this treatment to me, on a theoretical basis, is that it answers two of the deficiencies in most cancer therapies. One, it is not mutilating, and it is non-toxic. Secondly, you are treating cancer as though it is a disease of the body rather than as though it is just a disease of the local primary tumor site, which it really is not. Because if it were, most of the patients that do develop cancer would be cured whereas in reality it is just the opposite.