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From the Townsend Letter for Doctors & Patients
February/March 2003

Letter to the Editor
Coley's Toxins for Sarcoma and Intractable Cancer

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This is the story of the wonderful possibilities of Coley's Toxins. It is so simple to make and use.

First a word about William Coley MD. As a very young surgeon in New York City he was in 1891, age 29. He was able to get far greater fees than were many older surgeons. He had referred to him a 17 year-old young woman by the name of Bessie Dashiell who was a dear friend of John D. Rockefeller Jr. She lived near New York City and had taken a trip via rail to the Pacific Northwest. She had caught her hand on a seat in a railway car. The injury developed into round cell sarcoma. Coley amputated her arm but it was of no avail. She died a horrible death.
Her death weighed on Coley and he spent many hours after work going through the records of New York Hospital reviewing all sarcoma cases back to 1885. He said that there just had to be a better way to treat cancer.

He found an exciting case and clue to treating cancer: The patient was a very poor German living in an eastside slum in lower Manhattan. His name was Stein. He had round cell sarcoma on the neck and had had surgery for it three times. He had a huge malignant ulcer on his neck. He had been listed as an utterly hopeless patient. At this time he developed a severe infection of erysipelas. He survived the infection and in just a few days his huge malignant ulcer healed. He left the hospital in good health. That was in 1885. In 1891 Coley spent many hours searching for Stein in the eastside slums. At last Coley found Stein in good health and free from cancer.

Coley then decided to treat cancer by infecting the patients with erysipelas. He found a patient by the name of Zola who was another poor immigrant living in the lower east side of Manhattan. Like Stein he had sarcoma of the neck but also of the tonsil. The tumor on the tonsil, was blocking food intake. It seemed likely that he would die of cancer but also he was in danger of death from starvation. After several attempts, Coley was able to infect Zola with a severe infection of erysipelas which nearly caused his death. He had a fever of 105.5 with vomiting but as in the case of Stein, his malignant tumor healed and the tumor on his tonsil decreased so that he could again swallow food. Zola was in remission from cancer.

When Coley tried to infect other cancer patients with erysipelas, he could produce no infections. In two cases he was able to infect the patients but they died of the infection.

It was then that Coley made a killed vaccine of the streptococcus of erysipe1as. It had but little anticancer activity. Then Coley added to his killed vaccine, the newly discovered bacterium, Seratia marcescens. It was said to be non-pathogenic with humans. So a killed vaccine of the streptococcus of erysipelas and S. marcescens was made. It was killed by heating to 70°C and this was Coley's Toxins. It contained the dead bacteria and the endotoxins which they had produced. At a proper dose it was harmless.

Early on, a cancer patient was referred to Coley who was thought to be hopeless. He was 16 year-old John Ficken. It had been biopsy – proven to be sarcoma. It caused a huge bulge in his abdomen and much pain. Coley gave the first injection of his new vaccine into this huge tumor. The reaction to the injection was the same as an infection of erysipelas. The patient first had chills and shaking followed by fever. The injections were given every other day.

In the case of a severe infection of erysipelas, the tumor healed quickly. Here the process worked more slowly but the huge tumor started to decrease in size and there was marked pain relief. Injections were started on January 24, 1893. By May 13, 1893 the tumor was almost gone, the boy had gained ten pounds in weight. Coley sent the boy home. He lived a normal life until 1919 when he died of a heart attack at age 47. So Coley had an astounding success in treating his first cancer patient. The duration of treatment was three and a half months.

The treating of cancer with Coley's Toxins was quickly used by Coley and other doctors with much success but on December 15, 1994 there was an editorial in the Journal of the American Medical Association saying that Coley's Toxins was useless in the treatment of cancer.

However other doctors were beginning to use Coley's Toxins in treating cancer. In December 1895, Dr. Storrs of the Hartford, Connecticut Hospital had a patient with breast cancer. She was losing strength and weight. Her tumor was the size of an orange. Coley's Toxins were injected into her tumor. Thirty-nine injections were given between mid-December 1895 and mid-March 1896. By then there was no sign of a tumor. The patient had regained the 25 pounds of lost weight. She died in 1943 at age 80 of a cause other than cancer.

What was unusual about this case was that there was a discharge of necrotic tissue that had to be removed by drains. In most cases of treatment of cancer with Coley's Toxins, the tumor will decrease in size without the formation of necrotic tissue. When it happens, drains must be established.

The Mayo Brothers advised all cancer patients who had surgery for cancer at their hospital to return home and find a doctor who would treat the patient with Coley's Toxins for at least two months.

In the spring of 1896 Coley had said that so far he had treated 190 patients with far-advanced sarcoma with Coley's Toxins and over half of them had shown tumor reduction and a marked improvement in well-being and good health.

In 1898 Coley joined the staff of Memorial Hospital in New York City, now Memorial Sloan-Kettering Cancer Center and he took over the sarcoma ward there.

Read in any medical dictionary and one will find Ewing's sarcoma. Dr. James Ewing joined Memorial Hospital as pathologist at about the same time that Coley did. In 1896, the X-ray machine came on the scene and two years later radium was discovered, Ewing became an ardent believer in X-ray and radium as being the utopian cures for cancer and at the same time he developed a vehement hatred for Coley's Toxins.

Ewing developed a frienship with James Douglas who was CEO of the Phelps Dodge Corp, which firm was big in copper mining. Ewing interested him in radium both in the mining of it and in using it to treat cancer. Douglas had a daughter with breast cancer. Ewing came on strong for radium as a treatment for breast cancer so Douglas, his daughter and Ewing went to England where his daughter was one of the first cancer patients to be treated with radium. The treatment failed and Douglas' daughter died of breast cancer. This came after the success in treating breast cancer with Coley's Toxins in 1896 related above.

In time Phelps Dodge became a major producer of radium. Douglas made a gift to the Memorial Hospital of nearly half the radium in the world. Douglas demanded a quid pro quo. For the gift, Ewing was to be made head of cancer treatment at Memorial Hospital. By 1913 when Ewing became Medical Director at Memorial Hospital Coley had treated several hundred patients with sarcoma, mostly of the bone with Coley's Toxins. Over one-third of them had complete regressions of cancer.

To treat sarcoma of the long bone, it was demanded that the limb be amputated. Coley had several patients where the limb was not amputated and on treatment with Coley's Toxins complete remissions were had.

When Ewing became Medical Director at Memorial, Coley was refused permission to treat any more patients with bone sarcoma with Coley's Toxins. They all had to be treated with radium. Over a seven year period, there was not one patient treated with radium to show any kind of remission. They all died of progressing cancer.

In 1923, Coley nearly died of a bleeding stomach ulcer that was brought on he thought, by the distress caused by Ewing's repression of Coley's Toxins and from seeing his patients with bone sarcoma die on treatment with radium.

At the time when Coley was not permitted to treat patients with bone sarcoma with Coley's toxins at Memorial Hospital, in New York City not far from Memorial Hospital, one of the most astounding success stories of treating hopeless cancer with Coley's Toxins was taking place.

The patient was a captain in the Merchant Marine. In 1925 he had one leg amputated above the knee due to Ewing's sarcoma as determined by Ewing. His doctors were S.L. Christian and L.A. Palmer. Within three months there were metastases beginning to form, the first one in the groin, one in the abdomen and a fist-sized tumor on his amputated stump. Beginning on January 5, 1926, treatment was started with Coley's Toxins. Mostly the injections were done in the buttocks but a few were injected into the tumor in the stump of his leg. Treatment was for six weeks. All tumors decreased in size.

Within four months, there was reoccurrence and tumors began to grow at an astounding rate. The stump of his leg had increased in size until it was 31 inches in circumference and the end of it was a great ulcer from which there was a foul smelling discharge. There were new metastases in the scalp and neck vertebrae.

Early in the treatment of cancer with Coley's Toxins, there had been three deaths from too large a dose. Then with the knowledge of a proper dose, there were several hundreds of cases treated with no problems. Christian and Palmer decided that in this disparate case, disparate treatment should be used. Injections were done each day into the ulcer in the stump of his leg. Reactions were severe but there was dramatic regression of all his tumors. He had only 28 days of treatment. By then the stump of his leg had returned to a normal size and the ulcer was nearly healed. All of the other metastases were either gone or were very small.

His doctors wanted to continue treatment but the patient refused more treatment. By early 1927 the patient was free from all signs of cancer. He remained in good health until 1959 when he died of a heart attack.

Meanwhile at the Mayo Clinic, Dr. Henry Meyerding had been treating 28 patients with bone sarcoma with X-ray, radium, Coley's Toxins and amputation. Of those, 14 had remained alive and seven of them had survived more than five years.

Dr. Ernest Codman of the Massachusetts General Hospital had for years sided with Ewing saying that Coley's Toxins was useless in treating cancer. Then in 1934 at a meeting at Memorial Hospital on bone sarcoma, Codman reversed himself and said that note should be taken that on occasions, miracles happened on treating hopeless cancer with Coley's Toxins.

One such miracle was in 1912 and the location was Kentville, Nova Scotia. The patient was a young woman age 26. She suffered from renal cell carcinoma. She had extensive metastases in the peritoneum. She was taken by a special car the 40 miles to a hospital in Halafax where a surgeon who had been trained by Lord Lister in Scotland did exploratory surgery. He took one look and sewed her up again. He felt that she was utterly hopeless and did not think that she would survive the trip back to Kentville.

In Kentville, her doctor gave her what he thought to be a lethal injection of Coley's Toxins. He thought to cause her death and end her suffering. As it were, the dose was just right to cause almost an instant remission of her cancer. She had 18 im injections in the buttocks over a 30-day period and six weeks later was free from all signs of cancer. The patient was traced 40 years later still free from cancer.

Meanwhile the life of Coley was reading like a Greek tragedy. He had commanded fees far higher than most surgeons were paid but he had lived beyond his means. In the 1929 stock market crash, he lost all his money, In ill health he did surgery to make a living and died in 1936. Coley's Toxins almost died with him.

In 1953, Coley's daughter, Helen Coley Nauts founded Cancer Research Institute. Since then it has grown large and prestigious. She published 18 monographs on treating cancer with Coley's Toxins. Every letter that her father had ever written she reviewed. The success stories of cancers cured by Coley's Toxins she verified and published. In all she found good records on just under 1,000 cases of treating cancer with Coley's Toxins. Of them there were nearly 500 cases where complete regressions of cancer were had and the patient was free from cancer five years later. In a great many cases the patient lived to old age to die from a cause other than cancer.

In 1955 she had Coley's Toxins made at the Memorial Sloan-Kettering Cancer Center, Coley's hospital. She got underway the treatment of cancer with Coley's Toxins in many parts of the USA. In February 1961 there was one case of a miracle to end all miracles. The place was the Baptist Hospital in Oklahoma City. The patient was a retired contractor who had had surgery for colon cancer followed by a massive recurrence of cancer. He had an enlarged liver and many metastases in the abdomen with ascites. His family physician had been tapping the abdomen each day and removing four quarts of bloody fluid. Bloody pleural fluid had been aspirated from the lungs every second day to the extent of about a quart. Malignant cells were found in the fluid removed from both the abdomen and the lungs. Death was expected at any moment.

On February 22, 1962, intradermal injections of Coley's Toxins were started. At the site of the injection, there was an extensive inflammatory reaction with pain so the dose given must have been large. There was an aching and shaking chill followed by a fever of 102°F that developed three hours following the injection. After the first injection, there was no more pleural effusion. After the third injection, there were no more ascites in the abdomen. In all, the patient had only eight injections over a period of eight days. The patient began to live a normal life and to regain 30 lbs. of lost weight. He left the hospital on March 10, 1963 showing no sign of cancer. He was traced alive and well in 1970, nine years after surgery for colon cancer.

The American Cancer Society was formed in 1913 and at once it sided with Ewing in saying that Coley's Toxins was useless in treating cancer. By 1961 at the time of the case of colon cancer in Oklahoma mentioned above, the attack of the American Cancer Society on Coley's Toxins had reached its maximum in vehemence. It was listed among the American Cancer Society's list of unproven therapies.

The American Cancer Society had pushed hard for the passage of the Kefauver-Harris Amendment of the Pure Food and Drug Act. It became the law in June of 1962. It had in it a grandfather clause under which any drug or vaccine, that had been used with success before 1962, would be legal for use under the new law. Aspirin was at once made legal but the American Cancer Society held that there was absolutely no record of Coley's Toxins having any benefit in treating cancer prior to 1962.

The FDA did not make Coley's Toxins legal under the grandfather clause and its use became illegal. There were many cancer patients in the USA who were showing progress on being treated with Coley's Toxins who had the treatment suddenly stopped.

There were other exciting uses of Coley Toxins other than in the treatment of cancer. In 1932 Dr. Harry J. Gray of the Veterans' Administration Hospital in Newington, Connecticut began treating patients with thromboangiitis obliterans (Buerger's Disease) with Coley's Toxins. The orthodox treatment of the ulcers and resulting gangrene was and is the amputation of the toe, the finger or the limb. In the period 1932 to 1934 Gray treated 26 patients with Buerger's disease. The symptoms were cold feet, a lack of a pulse and ulcers sometimes with gangrene.

Gray injected Coley's Toxins into the gluteus maximus muscle. Injections were done each day at a dose that would give a febrile reaction of 102°F. The duration of treatment was not mentioned, however the cold foot came to body temperature, a normal pulse was restored where there had been no pulse and ulcers even with gangrene, healed. One patient with Buerger's disease, after having had his foot ulcers healed by Coley's Toxin, was traced 12 years later working in an aircraft factory.

Gray reported no failures in this treatment. In 1934, the words myocardial infarction and atherosclerosis were not known to medicine, however Gray suggested that Coley's Toxins should be considered in the treatment of Raynaud's disease and arteriosclerosis.

It seemed that Gray had found that treatment with Coley's Toxins would restore circulation to the feet. How interesting it would be to find that treatment with Coley's Toxins would restore circulation to blocked coronary arteries and perhaps make angioplasty or bypass surgery unnecessary.

I have discussed Coley's Toxins with Dr. Salvator Moncada, Research Director of the Wellcome Research Laboratories and with Professor Leo Zacharski of Dartmouth Medical School.

Moncada said that in the reaction to both an infection of erysipelas and to Coley's Toxins, the L-arginine to nitric oxide pathway is activated for the production of greater amounts of nitric oxide. He thinks that the larger than usual production of nitric oxide has the effect of being cytotoxic to cancer cells but harmless to normal cells. Moncada feels that the main anticancer effect of Coley's Toxins is due to its activation of the L-arginine – nitric oxide pathway. He also says that nitric oxide is produced by the endothelium from L-arginine and that it greatly inhibits platelet adhesion while causing to be produced endothelium-derived relaxing factor which relaxes vascular smooth muscle. Moncada said that nitric oxide produced by the endothelium promotes a better vascular blood flow.

Zacharski says that Coley's Toxins contains some streptokinase which in a powerful way will lyse vascular blood clots.

Both the nitric oxide produced by Coley's Toxins and the streptokinase in Coley's Toxins could explain how it restored the circulation to the feet in Buerger's disease.

Coley's Toxins has been used to treat osteoarthritis. My friend R.K. Brown, MD of New York City sent me a copy of a letter to him from Frederick Adelman MD then of the Rolling Hill Hospital in Elkin's Park, Pennsylvania. The date was February 2, 1970. Here is some of the letter: "I first learned of the use of Coley's Toxins in 1937 when the Medical Director of the then "Jewish Hospital" in Philadelphia described its use in osteoarthritis. Dr. Joseph Doane had been Medical Director of the Philadelphia General Hospital from 1917 until 1919 and had begun to use Coley's Toxins in the arthritis clinic. He had been much impressed with its effectiveness and had set up the Arthritic Clinic at the Jewish Hospital and had instructed the physicians in the use of the toxins.
"I began to use the Parke Davis preparation when I started to practice in 1946. In those days we made a 1:10 in sterile dilution and then began with a dose of 0.1cc of the dilution subcutaneously. We would increase the dose at approximately weekly intervals until we arrived at a dose averaging 10 minims or approximately 0.6 or 0.7 cc. Most frequently there would be a local reaction consisting of soreness and some heat which would occur within a few hours from the time of the administration and last 24 hours or so. On only one occasion did I run into a serious systemic reaction in which the patient developed considerable hyperpyrexia and was uncomfortable for many hours.

"The interesting finding which was almost consistently reported by my patients and the patients of many of my colleagues at the Jewish Hospital and later at the Albert Einstein Medical Center, was the relief of pain and stiffness which resulted after some weeks of the use of the toxins. The Arthritis Clinic at the Albert Einstein Medical Center had a tremendous patient load and Dr. Abraham Rosenfeld treated almost every patient with osteo-arthritis with Coley's Toxins. There was generally no evidence of toxicity. There were ample opportunities to do all variety of studies on some of these patients and in no instance was there evidence of untoward side effects. I continued to use Coley's Toxins mainly through the generosity of Mrs. Nauts of the New York Cancer Research Institute until about three or four years ago when it became very difficult to obtain the toxins for this use. I have never doubted its efficacy in the management of osteo-arthritis. I decried Parke Davis' abrupt discontinuance of its manufacture. I agree that it has never been thoroughly documented and therefore I cannot express surprise at the lack of knowledge in its use in treating osteoarthritis. I am also sure that there have been thousands of cases of various types of fibromyositis in which it was used, simply because the average physician who used the toxins did not particularly care if it was a stiff-achy joint due to one or another reason.

"Please understand that the men who used the toxins were not all unscientific, hit or miss physicians. At the Philadelphia General Hospital and at the Albert Einstein Medical Center one has a representation of the academically-oriented medical minds of Greater Philadelphia. These two institutions were the seat of the most extensive use of Coley's Toxins."

From 1894 until 1905, Coley's toxins were made by B.H. Buxton, Professor of pathology at Cornell University. Buxton grew the two bacteria together. Buxton retired in 1906 and returned to his native England. Dr. Martha Tracy who had worked with Buxton made the vaccine until she retired in 1923.

The Parke Davis Company began to make and sell Coley's Toxins in 1898 and continued to sell it until 1962. They made a weak vaccine that did much harm to the name of Coley's Toxins. It was used at the proper dose for the potent Buxton or Tracy vaccines and gave no reactions and no benefit in treating cancer. Many of the doctors who had claimed that Coley's Toxins were useless in treating cancer had used the Parke Davis vaccine at the proper dose for the Buxton or Tracy vaccines and had found no benefit.

After 1923 there was only the Parke Davis vaccine to be had. It was used at a far greater dose than was used with the Buxton and Tracy vaccines and some of the most remarkable regressions of cancer were had with the weak Parke Davis vaccine.

In 1993, I told Don Carrow, MD of Clearwater, Florida how to make Coley's Toxins. The live culture can be had of the two bacteria for $25 each. He made some Coley's Toxins. He told me of one success in using Coley's Toxins in treating cancer:

The patient was a 50 year-old nurse with non-Hodgkin's lymphoma. She had a tumor under one arm that was the size of a football. Carrow injected his Coley's Toxins into the center of that huge tumor. It shrank down to a flabby bag which was excised. It contained no live malignant cells. I have not known what Carrow has been doing with Coley's Toxins since then.

A few years ago, I went to Guatemala and had made a lot of Coley's Toxins. About four months ago, I delivered a lot of that Coley's Toxins to my friend Glen Wilcoxson, MD here in Spanish Fort, Alabama.

So far he has treated two cancer patients with it with indications of success. He has found some interesting things about treating cancer with Coley's Toxins. In 1900, doctors feared to put anything in the vein. Coley and other doctors did no intravenous infusions of Coley's Toxins. They injected only in a tumor or did injections into a muscle. Dr. Wilcoxson has found that injections done IV are far more effective than done im or into a tumor.

In two cases in this letter we have told how near lethal doses were given that produced complete remissions in less than 30 days. Another case of a great overdose of Coley's Toxins was in 1901 and the place was Costa Rica. The patient was a young woman with a rapidly growing cancer of the nasopharynx. She was being treated with increasing doses of the Parke Davis vaccine with no reactions and no benefit. Some Buxton vaccine was found and in desperation a very big dose of it was given. Clearly it was a great overdose.

The injection was done at 11:00 a.m. on May 8, 1901. All her tumors at once took on a high purple hue. Her fever rose to 105° and her pulse dropped to where it could not be detected. Huge amounts of necrotic tissue formed that had to be removed by forceps to prevent asphyxia.
Injections were given of caffeine and digitalis as a stimulant. After 12 hours the fever subsided and the pulse returned to normal. Then at 3 a.m. on the following morning the swelling in her face was gone, and her tumors had been reduced by half. By 72 hours after the one injection, one tumor the size of an orange was gone and another large tumor was reduced to the size of a small nut.

It is not suggested that patients have such large doses of Coley's Toxins but doctors now can control a reaction to Coley's Toxins in a way that Coley could not do. A rectal suppository Tylenol will terminate a reaction to Coley's Toxins at once.

In a reaction to Coley's Toxins there is fever and when the reaction is right, the pulse will increase to about 125. A doctor can give what is known to be a big dose of Coley's Toxins, then if the pulse exceeds 140 or the temperature exceeds 104, the reaction should be terminated with Tylenol.

There were many remissions from advanced cancer had in Coley's time. By using IV infusions of big doses of Coley's Toxins and by having Tylenol to terminate a reaction if one thinks it to be too severe, one should get far better results in treating cancer than were had in Coley's time.

Wayne Martin
25 Orchard Court
Fairhope, Alabama 36532 USA
Fax 251-928-0150

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