Aug 01 2017

Snake Oil 1970s Style

laetrileOn a recent post I repeated my long challenge to name any alternative medicine treatment that has been rejected by CAM proponents because of evidence of lack of efficacy. I am not aware of any. It doesn’t seem to ever happen – because alternative medicine is disconnected from evidence and reality.

As if to make my point, I came across this article on Buzzfeed about laetrile – yeah, laetrile. For those of you old enough to remember, laetrile is a fake cancer cure that was already being made fun of on Saturday Night Live in the 1970s (the original cast). I haven’t heard of this one for a while, but apparently it is making a comeback.

The story of laetrile, in addition to demonstrating yet again that snake oil peddlers are con artists, also showcases how the world has changed in the last forty years when it comes to health fraud (hint – not for the better).

A quick history of Laetrile

Here is a good summary of the history of Laetrile from Dr. Benjamin Wilson, writing for Quackwatch.  The article is titles, “The Rise and Fall of Laetrile.” An update would have to include. “A rise again.”

Laetrile is the trade name for laevo-mandelonitrile-beta-glucuronoside, a substance allegedly synthesized by Ernst T. Krebs, Jr., and registered with the U.S. Patent Office for the treatment of “disorders of intestinal fermentation.” This compound is chemically related to amygdalin, a substance found naturally in the pits of apricots and various other fruits. Most proponents of Laetrile for the treatment of cancer use the terms “Laetrile” and amygdalin interchangeably.

Amygdalin was originally isolated in 1830 by two French chemists. In the presence of certain enzymes, amygdalin breaks down into glucose, benzaldehyde, and hydrogen cyanide (which is poisonous). It was tried as an anticancer agent in Germany in 1892, but was discarded as ineffective and too toxic for that purpose. During the early 1950s, Ernst T. Krebs, Sr., M.D., and his son Ernst, Jr., began using a “purified” form of amygdalin to treat cancer patients. Since that time scientists have tested substances called “Laetrile” in more than 20 animal tumor models as well as in humans and found no benefit either alone or together with other substances. Along the way its proponents have varied their claims about Laetrile’s origin, chemical structure, mechanism of action, and therapeutic effects. Its place in history is assured, however, as a focus of political activities intended to abolish the laws protecting Americans from quackery.

Amygdalin is a poisonous chemical. There is nothing wrong with that, all drugs are poisonous chemicals (in high enough dose). If it could be purified, tweaked to have useful pharmaceutical properties, and was found to have a dose range in which it has a useful effect with tolerable side effects, amygdalin could have been turned into a useful drug. But, like most substances, it turned out not to be useful. I don’t know why Krebs hit upon amydalin for his fake cancer cure – perhaps because he found a reference to the German doctors who flirted with the idea in 1892.

This is where John Richardson picks up the ball – he claimed that laetrile, which he called “vitamin B17”, was a nutrient and that cancer was the result of a deficiency of this nutrient. His approach, it would turn out, was prophetic. He hit upon a strategy for selling snake oil that would contribute significantly to the alternative medicine world we have today. In June of 1972 Richardson was arrested and jailed for quackery. He eventually lost his medical license and was  charged with of smuggling illegal drugs from Mexico.

Richardson, it would turn out, was a sacrificial lamb for the alternative medicine revolution to come. His arrest resulted in the formation of the Committee for Freedom of Choice in Cancer Therapy. The lobbied for laws allowing for the sale of Laetrile, and eventually 27 states passed such laws. Wilson writes:

In 1977, a U.S. Senate subcommittee chaired by Senator Edward Kennedy (D-MA) held hearings on Laetrile that developed interesting testimony. Dr. Richardson claimed that the FDA, AMA, NCI, American Cancer Society, Rockefeller family and major oil and drug companies had all conspired against Laetrile. Robert Bradford said that he would welcome a test of Laetrile but that “orthodox medicine was not qualified” to do one. However, he Krebs, Jr., and Richardson were unable to agree on the formula for Laetrile. Senator Kennedy concluded that the Laetrile leaders were “slick salesmen who would offer a false sense of hope” to cancer patients. The New York Times commented that the Laetrile promoters were regarded by the Senators “with a blend of amusement and contempt.”

Of course there are many other players and factors involved, but the story of laetrile is at least a microcosm of the broader story of alternative medicine. The elements were all there – blaming “Big Pharma” for being at the center of a conspiracy to hide the truth of this miracle natural cure, that was really only a nutrient. Meanwhile the people selling this toxic and worthless drug were making false claims and millions of dollars.

What is amazing to me is that, in the last forty years, the con artists have essentially won. The laetrile affair simply created the infrastructure and the marketing strategy they would need to convince enough of the public that their narrative was true. That narrative is that the powers that be don’t really care for their health. We live in a toxic world where evil powerful forces are trying to poison you so that they can make money off your illness. Meanwhile, brave maverick doctors and “healers” are out there, fighting the forces of evil to bring you natural cures. All we need to fight these evil forces is freedom – the freedom to make our own choices about the medicines we take.

In a way it is a compelling narrative. Every person who is sick or has a loved one who is sick (in other words, most people at some point in their life) would want to believe that a gentle natural cure is out there. All they need is an open mind and a credit card.

This narrative is also very lucrative, to the tune of billions of dollars. That kind of money feeds off itself. It created the lobbying power to change the laws so that the sellers of snake oil could make even more money, which would give them more marketing and lobbying muscle. The internet then gave this narrative jet fuel.

Along the way we had DSHEA, which made it so the FDA has essentially no power to regulate “supplements” which could also be marketed with “structure function” claims. Health care con artists got more and more savvy. They realized, especially with social media, they could have their customers make illegal claims for them. They just have to suggest health claims (by making structure/function claims), and then they could pay a fake expert to say how great their product was, while offering testimonials. Customers became proponents.

They also formed a symbiotic relationship with the media, who would get great ratings from their sensational stories, while promoting the snake oil peddlers. Dr. Oz essentially made a successful career out of this model.

It is not surprise then that Laetrile is making a comeback in this new environment. It is being sold as a supplement, without any claims that it cures anything. They don’t have to make those claims, they are already out there in the culture and on social media. Any doubts about evidence or effectiveness are waved off as a conspiracy. Anyone who would talk sense about the need for controlled studies is obviously part of the Big Pharma cabal, a paid shill.

The public has their comforting narrative, and are apparently willing to shell out billions for it. Doctors, regulators, skeptics, and scientists are all evil corporate shills. Politicians and the media are happy to collude with the con artists, as long as the donations and ratings come in. Some of them believe the narrative also, so the lines between believer and con artist are very blurred.

At the center of all this, lost in the noise, is the humble lonely fact that amygdalin (by any other name) is a toxic substance without any medicinal use. It is not a nutrient, let alone a vitamin. There is no evidence it cures cancer, or any other disease. It has already been studied and found to be useless as a cancer treatment.

But the profitable narrative has won out over the facts.

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