The Generalist

Laetrile Revisited

In a previous post I suggested that when you eat an apple you might want to also eat the seeds which contain amygdalin, a substance that inhibits the growth of cancer cells. Recently, I came across an article published this year in the Internet Journal of Alternative Medicine entitled Inaccurate Reporting of the Effects of Laetrile: Mistreatment of Ellison, Byar and Newell. While I’m happy to see someone bringing this topic to the forefront again (it is especially timely in light of the recent court decision to force 13-year-old Daniel Hauser to undergo chemotherapy), I’m concerned about the effect it will have on the writer’s reputation. It seems that no matter how reputable you were before you argue in defense of Laetrile or amygdalin, you become a raving lunatic suitable for committal immediately after you do. (This, of course, is just one of the things that ought to make you suspicious.) Already here and there on the internet are the usual loud and bizarre complaints that “apricot kernels are poison!”, “there’s no evidence they cure cancer!”, and “these people are just trying to earn a profit off sick people!” as IF traditional chemotherapy is harmless, evidently cures cancer, and doesn’t make somebody somewhere a nice fat profit. All this while those who attempt to argue that Laetrile might actually work lose their credibility, their licenses to practice medicine, and sometimes their freedom. As John Stossel would say “Give me a break!”

For those of you who are new to this debate and may be struggling to figure out for yourself who is correct and who is deluded I have a few links for you to check out.

Eating Apricot Kernel in Egypt – This is a fascinating blog by a native Egyptian discussing the plants he likes to grow in his garden and the traditional foods made from them. He is apparently still alive and kicking despite eating these highly poisonous apricot kernels on a regular basis. And he points out that this practice has been going on in Egypt for thousands of years.

Contrast that with this article from 1979 (the height of the Laetrile controversy) published in the peer-reviewed American Journal of Clinical Nutrition entitled Laetrile: the cult of cyanide. Promoting poison for profit. Just a few quotes from this obvious hit piece:

“The laetrile empire is a highly organized and lucrative industry using sophisticated computerized technology, levels of funding undreamed of by the “snake oil salesmen” of old, with enormous impact on federal, state, and local levels of government.  It has the ability by push-button to generate avalanches of mail, massive funding for candidates supporting laetrile. It has an interlocking network of direct mail, an interlocking network with other organizations promoting health quackery, exerts unrelenting pressures on elected officials, and is not above smearing and threatening responsible scientists who dare to challenge it.”

Now for those of you unfamiliar with the psychological principle of projection, this is really a bizarrely classic case of it. In truth Laetrile proponents are utterly powerless against the real culprit being described here. Do I really need to say more?

“The process of cyanide release from an apricot kernel is analogous to dropping a sodium or potassium cyanide pellet (these salts of cyanide are highly water soluble solids) in water or acid, the means of “gas chamber” executions in California and genocidal mass killings by the Hitler regime during World War II.  Ironically, various leaders of the Third Reich, including Himmler and Goering, ultimately committed suicide by bitting into, and thereby crushing, cyanide pellets.”

Yes, you heard that right. Now, take THAT you Egyptian farmers!

Despite all of this bad press,and contrary to what you might expect, there are still amygdalin studies being done today, but they are done mainly by Asian scientists. Here are two fairly recent articles from the Biological & Pharmaceutical Bulletin which is published by the Pharmaceutical Society of Japan:

Amygdalin Induces Apoptosis through Regulation of Bax and Bcl-2 Expressions in Human DU145 and LNCaP Prostate Cancer Cells (2006)

Antinociceptive Effect of Amygdalin Isolated from Prunus armeniaca on Formalin-Induced Pain in Rats (2008)

This one is from the Department of Pharmacology at Kyung Hee University, Seoul, South Korea and was published in The World Journal of Gastroenterology –Amygdalin inhibits genes related to cell cycle in SNU-C4 human colon cancer cells (2005)

In an interesting discussion on another blog, one skeptic points out that the two cancer studies above were done using in vitro cancer cells – meaning they are in a petri dish, not in a living organism (experiments that use living organisms are called in vivo). This is true and is a good point, however, they are put forward here not so much because they are proof of amygdalin’s efficacy, but because they show that these Asian scientists are in fact still interested in conducting experiments while all such experimentation is dismissed out-of-hand in the west. (The other experiment listed here has to do with controlling pain and it was done with live animals. This effect that was also noted by the original proponents of Laetrile.)

In response to the skeptic (or overly credulous depending on how you look at it) above I would like to mention that evidence of the efficacy of amygdalin was shown in positive animal studies that were done in the 70’s. They were performed by Kanematsu Sugiura at Sloan Kettering but they were never officially published. They were, however, leaked by individuals working at Sloan Kettering at the time. Although I have managed to obtain a copy of them, I unfortunately do not have an electronic version at this time and have not been able to locate one on the web. (Update: See Kanematsu Sugiura’s Sloan Kettering studies here.) There is, however, an article written in 1976 by investigative reporter David M. Rorvik entitled Laetrile: The Goddamned-Contraband-Apricot Connection that is available online and that provides a good overview of the entire controversy.

For me, the apparently desperate attempts from the powers that be to prevent people from learning about the nutritional effects of amygdalin, (reference the insane quotes listed above), the fact that people have been eating foods containing it for thousands of years, Sloan Kettering’s suppressed positive animal studies showing an inhibitory effect on tumors in mice (bred specifically to spontaneously develop cancer), the fact that other scientists from around the world are still interested in studying it, proponents’ intelligent statements regarding the medical establishment’s focus on the size of tumors rather than the number of malignant cells in them, and the fact that it is present in a host of otherwise particularly nutritious foods, (apricot seeds, apple seeds, millet, lingonberries, mulberries, and blackberries to name a few) provide evidence that amygdalin does in fact have anti-cancer properties. You will still need to decide for yourself.

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16 Comments

  1. Stephen Krashen

    13 Jun 2009 - 12:40 am

    Thanks for your informative blog essay!

    I’m the author of the journal paper you mentioned at the beginning of this blog. I published another paper, discussing the famous Mayo clinic study that supposed showed once and for all that Laetrile is quackery. All the study really showed is that if you use terminal patients, a weaker form of Laetrile, use an inflexible schedule of administering Laetrile, and ignore all signs of positive evidence, you get a negative result.

    Stephen Krashen 2009. Does Laetrile work? Another look at the Mayo Clinic study (Moertel et al., 1982). The Internet Journal of Alternative Medicine, vol 7 Number 1.

    More to come, I hope … At the moment it seems to me that the Laetrile argument has been hijacked by extremists on both sides, with the establishment rejecting Laetrile prematurely and the anti-establishment claiming it is a miracle cure.

    The professional literature has a number of reports of patients who did well with Laetrile, reports written by professional physicians who reported the cases carefully, and are not in the business of selling apricot pits. These cannot be ignored, and there are too many of them to attribute all to fraud, misdiagnoses or spontaneous remission.

    I hope a rational path can be followed with the use of Laetrile, a thorough investigation of its potential as a treatment for and preventative of cancer.

  2. Lisa

    13 Jun 2009 - 6:25 pm

    Dr. Krashen,

    Thank you for your comment and also for your courage. I’m sure you are getting a lot of abuse for your views. What you say about Laetrile being “hijacked” is precisely correct. At the risk of sounding “conspiratorial” I don’t think this is an accident. I will have more to say about this process in a follow up post. In the meantime, I’m going out further on a limb and creating an electronic version of those original leaked Sloan Kettering studies which I will make available for anyone who would like to see them for himself. If you publish anything further, by all means, feel free to include a link to it here. For those who are interested, here is the link to Dr. Krashen’s above referenced paper: Does Laetrile Work? Another look at the Mayo Clinic study

  3. Stephen Krashen

    14 Jun 2009 - 1:11 pm

    There has actually been little abuse, and I invited most of it by posting a summary of my results on a website devoted to “science” http://www.sciencebasedmedicine.org/?p=414#comments. I wanted to find out if the anti-laetrile people had any “scientific” arguments. None whatsoever. Only nasty rhetoric, accusing me of being a hustler. The only trace of an empirical argument was from an oncologist who said he had evidence that patients who took laetrile didn’t live as long. I contacted him personally. It turned out he did not control for stage of the disease! And had lost the data. This was very disappointing.

  4. Lisa

    17 Jun 2009 - 2:41 pm

    You are very patient. These so-called doctors display the ignorance and undue hubris associated with the idea that going to school and having a few letters attached to your name automatically makes you knowledgeable and from that point forward you no longer have to think, work, study, or actually support any position you hold. I mean, surely, how could a mere linguist (or in my case, worse, an artist!) know anything about medicine? Could it be that we can read, understand and make arguments without ever having set foot into a medical school? Nah….

    I wonder if they even know what an ad hominem fallacy is.

    Some of these comments are pretty funny though. Here’s a hilarious ad hominem, worthy of mention:

    “One thing I’ve noticed is that there are a fair number of Holocaust deniers who are also into alternative medicine.”

    Well! That’s settles the argument!

    “Good grief! It is cyanide! What part of that being both dangerous and useless do you have trouble grasping?”

    Well, except for offing yourself. I mean after all, eating apricot seeds is “analogous to dropping a sodium or potassium cyanide pellet.”

    My very favorite response to the whole argument is the comment on the Northern Doctor blog, made by Gyasi, an Egyptian American who says “I’m having a good chuckle here because I’ve eaten tens of thousands of apricot, apple, and peach seeds in my lifetime, and I’m perfectly healthy.” After that, I notice there is total silence.

    If you haven’t had a chance to take a see them for yourself, you might want to check out Sugiura’s original lab studies with mice.

  5. Michael

    23 Aug 2009 - 6:06 pm

    Replying to Stephen Krashen, who wrote:
    “I wanted to find out if the anti-laetrile people had any “scientific” arguments. None whatsoever. Only nasty rhetoric, accusing me of being a hustler.”

    I cannot speak for HCN. He was a little angry and hence a bit vitriolic, but that’s kind of understandable when you consider the fact that he’d seen several patients who’d needlessly had cyanide poisoning because they’d followed a dubious “cancer treatment”.

    Here’s an analogy: imagine you were working on a painting, and you’d nearly finished it after working on it for months, except it wasn’t quite right for some reason and you couldn’t figure out quite why. So you invite some close friends over to come and have a look at it, and one of them brings their drunk mate who says “I know, it needs a giant pink smiley face right in the middle” and before you can say anything, he grabs a brush and a pot of pink paint and slaps it all over your painting, ruining your brush and ripping a hole in the canvas at the same time. You’d be pretty pissed.

    But, however, I can speak for myself, and I have to defend my attitude because I don’t think Stephen’s account of the responses he received is fair. I was very polite, and gave sound arguments as to why I disagreed. I’m still awaiting a reply, addressing my points.

  6. Lisa

    25 Aug 2009 - 12:49 pm

    Michael,

    I cannot speak for Dr. Krashen, and I do not know what your points were. I also have no idea what your analogy is in reference to. As far as the doctor who became “angry” with proponents because his patient became ill after he attempted to treat himself I have only this to say:

    Assuming for the sake of argument that this is an accurate characterization of laetrile, and I do not believe it is, the fact that those who are ignorant of how to properly use it (and who have no access to a medical professional who does for entirely political reasons) might be sickened by it is not an argument against the merits of it as a treatment for cancer. (As your term “dubious” and the quotations you put around “cancer treatment” are meant to imply.) If it were, then you would have to admit that modern forms of accepted chemotherapy would fall most assuredly in the same category.

  7. Michael

    20 Sep 2009 - 6:20 am

    So you’re saying that all the people who’ve come down with cyanide poisoning as a result of going on a course of laetrile therapy did so because they did not know how to use it properly, and the reasons behind their ignorance are political? That’s absurd.

    The trouble with cancer is that it is such a difficult disease to combat. Part of the reason for this is that “cancer” can cover all sorts of different diseases, depending on the site (i.e. where on the body it is), what stage of development it’s in when it was discovered, and so on. This page explains it very well indeed: http://www.phdcomics.com/comics.php?f=1162

    The argument that the doctor raises is not about being sickened, but being sickened unnecessarily. Chemo is a horrible experience to have to undergo but for many it is the only viable option. Laetrile on the other hand was “discovered” by known charlatans, has extremely dubious evidence to back it up, is touted as a “one size fits all” cancer (which is demonstrably not how cancer works) and ultimately defrauds vulnerable families out of large sums of money. And then doctors have to waste time undoing the damage.

    Patient choice is all very well and good in theory, but that doesn’t mean that the choice should be between “something scary and risky but sadly the best and only evidence-based option we’ve got” and “a complete red herring”.

  8. Lisa

    22 Sep 2009 - 8:52 am

    “So you’re saying that all the people who’ve come down with cyanide poisoning as a result of going on a course of laetrile therapy did so because they did not know how to use it properly, and the reasons behind their ignorance are political? That’s absurd.”

    “That’s absurd” is not an argument. By all means post links to your sources for “all the people” who have been poisoned as a result of a proper course of laetrile. And DO read the reports of the scientist that did the original study on mice at Sloan Kettering. Please point out where any mice died from poisoning.

    “The argument that the doctor raises is not about being sickened, but being sickened unnecessarily.”

    Yes. And that is exactly what I addressed in my comment back to you.

    “Chemo is a horrible experience to have to undergo but for many it is the only viable option.”

    No, it isn’t. I think that’s already been made clear.

    “Laetrile on the other hand was “discovered” by known charlatans, has extremely dubious evidence to back it up, is touted as a “one size fits all” cancer (which is demonstrably not how cancer works) and ultimately defrauds vulnerable families out of large sums of money. And then doctors have to waste time undoing the damage.”

    Ad hominems are not arguments.

    “Patient choice is all very well and good in theory”

    Theory is all human beings have. And “patient choice” as you call it is part of a political theory. Political theory is something that you are clearly not familiar with.

    “but that doesn’t mean that the choice should be between “something scary and risky but sadly the best and only evidence-based option we’ve got” and “a complete red herring”.”

    Again, where is your evidence? Calling something “sadly the best and only evidence-based option” or a “complete red-herring” is not an argument. I recommend you start thinking for yourself.

  9. Anthony Martino

    26 Sep 2009 - 10:21 pm

    Brainwashing Quiz:

    Will companies with patented cancer drugs ever sell a cure for cancer that will be the inexpensive price of a common seed? Yes/No

    Would pharmaceutical companies ever knowingly sell drugs that could actually harm the general public? Yes/No

    If a hypothetical cure for cancer existed that was the price of a seed would less effective competitors have a monetary interest in prohibiting doctors from prescribing such curatives? Yes/No

    Could the profits reaped from apricot seed sales be used to manipulate the media, brainwash the general public, and rival the influence that comes from the billion dollar revenue streams of pharmaceutical companies? Yes/No

    Obviously, retaking this test even with certain words changed would not change your answer if the internal logic of the test remained the same.
    Such a thing could only happen if you had been the victim of brainwashing and the appropriate words appeared to trigger a “manchurian candidate” reaction that momentarily overrode your reasoning capacity. Now take the test again and replace the word pharmaceutical with the word tobacco.

  10. Michael

    27 Sep 2009 - 7:58 pm

    Thank you for the link to the report. I have read its contents and have the following comments, with specific reference to your question “where is [my] evidence?”.

    – Although it can be argued that Sloan-Kettering handled the controversy badly, this is in no way relevant to the quality of Sugiura’s work, or whether his results could be verified independently by other researchers, with or without Sugiura’s supervision.
    – Repeating trials to verify results is a normal part of scientific procedure, which is perfectly valid, because chance plays such a large role in trials – especially when the number of subjects is as small as the 30 mice in each group that Sugiura used. We need to be sure that Sugiura’s results didn’t occur by chance (you can’t conclude from a single roll of a die whether it’s loaded, for example) and we also need to ensure that there was no way the trial could have been biased. If laetrile worked in a properly designed and conducted trial, then it should work regardless of who conducted that trial, which lab it was conducted in, right? And furthermore, it should come out with a positive result in a trial where the investigator doesn’t know until afterwards, which mice have been given laetrile and which the saline. This procedure (called blinding) protects against the bias you get when the investigator simply just wants something to work.
    – When the trials were re-run, the investigators found that “The significance attributed to those early observations [i.e. Sugiura’s] is seriously challenged by the negative findings of 3 independent investigators, by 2 out of 3 negative cooperative experiments in which Sugiura participated, and particularly by the blind experiment in which he and others under blind readings found no anticancer activity.” (Stock et. al, 1978). In other words, under blinded conditions, no anti-cancer activity was found. It would appear that inadequate blinding is a reasonable explanation for Sugiura’s apparently positive results. In Sugiura’s notes, he completely fails to adequately describe how he ensured that his measurements were not subject to bias. Yes, one out of nine tests yielded positive results, but this can be reasonably attributed to chance (you roll a 20-sided die nine times, there’s a reasonable chance that you’ll roll a 1 at least once).
    – Furthermore, Dorr and Paxinos (1978) have this to say: “Substantial in-vitro and in-vivo testing in animal tumor systems has shown that amygdalin is entirely devoid of significant anticancer activity. Control animals often have lived longer than those treated with various doses and schedules of amygdalin. Acceptable clinical studies in humans are lacking, but such ventures would appear to be contraindicated from animal studies and observed human toxicities.”
    – I also refer you to the evidence presented by Wallace Sampson on the Science-based medicine blog linked to by Stephen Krashen above, particularly the part leading to the assertion “Laetrile was thought up by Krebs Jr. without any prior evidence. In other words, he made it up.”

    I agree with you insofar as the Sloan-Kettering Institute handled this case politically rather clumsily. However I don’t agree that this in and of itself constitutes evidence that laetrile is an effective cancer treatment, and this, really, is the key thing. Framing this entirely as a political theory issue is, in my view, a red herring.

    Funnily enough, on the ad hominem suggestion that I should think for myself, I think you’ll find it’s something I do quite regularly. For example, I’m perfectly happy to agree that pharmaceutical companies don’t always behave entirely ethically, have a tendency toward publication bias and so on. But the fact some of them do this sometimes doesn’t mean that they always do so, and (this is the key point) it doesn’t mean that the alternatives are automatically right.

  11. Lisa

    8 Oct 2009 - 8:54 pm

    Regarding Sugiura’s original tests being made without blinding him as to controls:

    The study was in fact repeated multiple times with Sugiura blinded. A problem arose because despite being blinded Sugiura was able to guess which mice had received laetrile. This is not surprising and in fact points to the efficacy of the drug. I myself was a participant in a drug study for a major pharmaceutical company. I received the placebo and my doctor – blinded as to which of his patients was receiving the medicine – in fact guessed that I was not. The truth is, the Sloan Kettering scientists were unhappy with the result. They therefore scrapped perfectly valid experiments, failed to release the results of a number of positive ones and finally conducted a blind experiment in which study mice and controls were mixed in the same cage, making it likely that lab technicians would administer laetrile to controls. Excellent experiment design – but it got the result they wanted!

    Furthermore, Dorr and Paxinos (1978) have this to say: “Substantial in-vitro and in-vivo testing in animal tumor systems has shown that amygdalin is entirely devoid of significant anticancer activity. Control animals often have lived longer than those treated with various doses and schedules of amygdalin. Acceptable clinical studies in humans are lacking, but such ventures would appear to be contraindicated from animal studies and observed human toxicities.”

    You might want to consider reading the actual post to which you have added your comment. There are three much more recent studies that address in vitro anticancer activity and one which addresses in vivo pain management.

    I also refer you to the evidence presented by Wallace Sampson on the Science-based medicine blog linked to by Stephen Krashen above, particularly the part leading to the assertion “Laetrile was thought up by Krebs Jr. without any prior evidence. In other words, he made it up.”

    This is a useless ad hominem. If you are referring to Krebs’ theory of how laetrile works, I have heard many arguments against it. But the theory of HOW something works is subordinate to evidence that it DOES. Nobody yet knows how gravity works, but no one questions it either.

    I agree with you insofar as the Sloan-Kettering Institute handled this case politically rather clumsily. However I don’t agree that this in and of itself constitutes evidence that laetrile is an effective cancer treatment, and this, really, is the key thing. Framing this entirely as a political theory issue is, in my view, a red herring.

    Talk about a red herring… My reference to political theory was in response to your statement regarding freedom of choice specifically and has nothing to do to whether laetrile works or not.

    Funnily enough, on the ad hominem suggestion that I should think for myself, I think you’ll find it’s something I do quite regularly. For example, I’m perfectly happy to agree that pharmaceutical companies don’t always behave entirely ethically, have a tendency toward publication bias and so on. But the fact some of them do this sometimes doesn’t mean that they always do so, and (this is the key point) it doesn’t mean that the alternatives are automatically right.

    Now that you know that pharmaceutical companies “don’t always behave entirely ethically” and that foundation and pharmaceutical company supported research institutes don’t always tell the truth, you will be more inclined to view their findings skeptically, right? And you’ve knocked down yet another straw man as no one has suggested that the alternatives are automatically right. Quite a few seem to believe that they are automatically wrong, though.

    For those interested in reading more about laetrile, I highly recommend, in addition to the links provided in my article, G. Edward Griffin’s World Without Cancer.

  12. SickOfLies

    25 Oct 2009 - 12:31 pm

    Thank you so much Lisa for linking Anatomy of a Coverup. I have been searching and searching for this :D

  13. Jack

    4 Mar 2012 - 10:36 am

    Hi Lisa

    Would you mind providing a reference for the details of the blind experiments that Sugiura and collaborators conducted, specifically a link and hopefully citation of the document is not available on-line about the fact that there was positive likelihood that the test and control mice were missed by lab technicians?

  14. Lisa

    4 Mar 2012 - 12:24 pm

    Hi Jack,

    I’m not sure exactly what you are asking me for, but you can find Sugiura’s lab reports here: Anatomy of a Coverup. There are some books that might help you, but most of them are either about general alternative cancer treatments (not just laetrile) or they are out of print. You can look for books by Ralph Moss. A good book on alternative cancer treatments is Outsmart Your Cancer: Alternative Non-Toxic Treatments That Work (Second Edition)With CD by Tanya Harter Pierce. If you are looking for articles in “peer-reviewed” journals you won’t find them. Good luck! If you do find something interesting, I’d love to hear about it!

    Oh, and I should mention… I have links to them here on the blog, but if you’re just surfing, you may not have seen them… G. Edward Griffin’s World Without Cancer: The Story of Vitamin B17, and also video: A World Without Cancer.

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