Researchers from Columbia University have reported that patients receiving Gemzar® (gemcitabine)-based chemotherapy for inoperable pancreatic cancer have a longer survival and better quality of life than those receiving an alternative medicine approach consisting of enzyme therapy, nutritional supplements, detoxification, and an organic diet. These results were published early online in the Journal of Clinical Oncology on August 17, 2009.[1]

Pancreatic cancer has one of the highest mortality rates of all cancers. It accounts for less than 3% of all newly diagnosed cancers in the United States each year but 6% of all cancer deaths. Pancreatic cancer is often called a “silent killer” because its symptoms are usually not recognizable until it has advanced and spread outside the pancreas. As a result, the majority of pancreatic cancers are not diagnosed until they have reached advanced stages and are considered incurable.

Because outcomes after conventional treatment of advanced pancreatic cancer remain poor, some patients seek alternative treatments. To compare conventional chemotherapy to an alternative treatment regimen, researchers designed a Phase III clinical trial. The trial was intended to compare Gemzar-based chemotherapy to an alternative treatment regimen consisting of pancreatic proteolytic enzymes, nutritional supplements, detoxification, and an organic diet. Pancreatic proteolytic enzymes had shown some promise against pancreatic cancer in preliminary studies.

Because most patients refused to be randomly assigned to treatment group, the design of the study was eventually changed to allow patients to choose treatment group.

Patients who chose to be treated with Gemzar often received Gemzar in combination with other chemotherapy drugs such as Xeloda® (capecitabine) and Taxotere® (docetaxel).

Patients who chose to be treated with enzyme therapy also consumed a diet that required at least 70% of the food to be raw or minimally cooked. Patients in this group also underwent detoxification with coffee enemas twice a day, skin brushing and cleansing, salt and soda baths, and a liver flush.

Of the 55 patients with inoperable pancreatic cancer enrolled in the study, 23 chose chemotherapy and 32 chose enzyme therapy.

• Median survival was 14 months in the chemotherapy group and 4.3 months in the enzyme therapy group.
• At one year 56% of the chemotherapy patients were still alive compared with 16% of the enzyme therapy patients.
• Patients in the chemotherapy group reported better quality of life than patients in the enzyme therapy group.

Comments: These results suggest that treatment of pancreatic cancer with Gemzar-based chemotherapy results in longer survival and better quality of life than treatment with enzyme therapy. The median survival of the chemotherapy group was longer than usually observed in recent studies. However, all recent studies of chemotherapy for advanced and metastatic pancreatic cancer resulted in longer median survivals than in the alternative medicine arm of the present study. It should also be pointed out that a median survival of 4.3 months for the alternative medicine arm of the current study is somewhat less than the median survival of 5.2 months reported in 1998 for the supportive care arm in a study from Greece evaluating 5-FU regimens.[2] This suggests that the alternative medicine arm in the current study may not even be better than a best conventional supportive care arm. This raises the possibility of harm with this alternative medicine approach to the palliation of pancreatic cancer.

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