Cancer & Krebiozen

Over a 500-watt local radio station comes the well-modulated voice of Narrator Walter McGraw in a soft-sell, sincere-sounding pitch for "a fair trial for Krebiozen." (The recording bore the imprint of Manhattan Adman Robert M. Marks, fronting for the Krebiozen Research Foundation.) Into the mails every month go 25,000 or more copies of the Bulletin of the Citizens Emergency Committee for Krebiozen (pronounced Kre-by-ozen).

The American Cancer Society's last fund drive was bedeviled by protest cards (thoughtfully provided by the Krebiozen lobby) reading: ". . . I will resume my support of the A.C.S. when your organization supports the truth about Krebiozen and commits itself to an unbiased clinical test about Krebiozen." G. P. Putnam's Sons, publishers of pro-Krebiozen books, promote them with gaudy red, black and yellow throwaways with such unprovable headlines as REAL HOPE TO CURE CANCER and BIG LIE BANS CANCER DRUG.

Dangerous Delay. For the tens of thousands of U.S. cancer victims whose cases are pronounced hopeless in any given year, the unresolved argument over Krebiozen creates a personal emergency of tragic intensity. By pretending that the cancerous Krebiozen controversy does not exist, organized medicine represented by the American Medical Association and the American Cancer Society is acting on the assumption that "if we don't look, it will go away." This, as A.M.A. and A.C.S. are both quick to assert, is the cardinal sin of patients who delay in taking their lumpy growths to a doctor.

What is Krebiozen? Nobody knows for certain (and some extreme skeptics still question whether there is such a. thing).

Does it do any good? Nobody can be sure, on the basis of the ill-organized and sketchy evidence so far available.

Krebiozen is the creation of an intense, sunken-eyed Balkan medico named Stevan Durovic. Now 55, Dr. Durovic got his M.D. at Belgrade in 1930, was a medic in the Yugoslav army when captured by the Italians in World War II. Thanks to a heart condition, P.O.W. Durovic was allowed to leave Italy on a Vatican visa in 1942 for Peron's Argentina.

There, Dr. Durovic began to apply a theory which, he now says, he had been mulling over for years: that some of the body's defense mechanisms, including those against cancer, are seated in the cells of the reticulo-endothelial system* (RES for short). By 1946 Dr. Durovic had a substance, extracted from the blood of specially treated cattle, which he called Kositerin and considered promising for treatment of high blood pressure.

Dr. Durovic came to the U.S. in 1949. At Chicago's Northwestern University Kositerin's effectiveness was proved to be almost nil. But Durovic was referred to the University of Illinois' Physiologist Andrew Conway Ivy. When Durovic saw Ivy, he told him that he had a drug named Krebiozen, extracted from horse blood, for treating cancer. Some scoffers assert that Kositerin became Krebiozen during a cab ride across town.

Hippodrome Show. Ivy was indeed interested. A show-me farm boy of Scottish extraction from Farmington, Mo., Dr. Ivy had made it the hard way to the top ranks of medical research. In 1949 he was 56, loaded with honors, vice president of the professional colleges of the University of Illinois, author of more than 1,000 technical papers on research. Though an M.D., Ivy was a physiologist and teacher, no bedside physician. Satisfied that Krebiozen was both harmless and promising, the Ivy team injected it into 22 patients nearly all of whom were diagnosed as having last-stage cancer ("terminal cases"). Though most of them soon died anyway, some felt better for a while, and after 17 months two of them were reported free of cancer.

What happened next is history. Early in 1951, at a meeting in Chicago's Drake Hotel, Dr. Ivy reported his findings to the medical profession, press and public. It turned into a hippodrome performance, But why this happened is still a mystery Dr. Ivy insists that word of miraculous benefits from Krebiozen was leaking out, and he wanted to set the record straight. Dr. Durovic gave his conventional critics a club to beat him with by refusing to tell how he made Krebiozen, claiming that he feared the Communists would get hold of it. This left Krebiozen a secret remedy, which is anathema to medical ethics and ethical medics.

The A.M.A.'s Council on Drugs hastily pulled together reports on 100 patients treated with Krebiozen at seven clinics and concluded that the stuff was valueless. The Chicago Medical Society suspended Dr. Ivy for three months for promoting a secret remedy. University President George D. Stoddard recommended that Ivy be demoted from his vice presidency but left him on the faculty. Then the circus moved under the big top. An Illinois legislative committee held hearings for a year, ended by rebuking President Stoddard. The National Research Council undertook a study of Krebiozen, but still relied on second-hand evidence. The findings, predictably, were negative.

Around the Rule. Meanwhile, desperate cancer patients and their families clamored for Krebiozen, and by now an estimated 3,000 have had injections of it from about 300 physicians. With this number of cases, it ought to be easy for scientists to determine whether the stuff is any good. But last week the New York Post devoted six data-packed pages to the controversy and explained why no impartial judge can yet assess its value.

Krebiozen is approved "for investigational use only." It cannot be sold. A doctor must get it from the Krebiozen Research Foundation for cancer cases of the types that the foundation approves of treating, and he is required by law to give the foundation a report of his results. In practice, he usually makes a "donation" of $9.50 for each ampule (one injection), which gets around the no-sale ruling. Then, all too often, he neglects to file a report.

For $9.50 what does the patient get? Dr. Durovic says he brought less than a --teaspoonful--two grams--of the whitish powder from Argentina. This would mean that" it" had been extracted from 2,000 horses (costly, because the horses are killed in the process), as Durovic says he gets only about one milligram per horse. And the human dose of Krebiozen is so fantastically minute--only 1/100 of a milligram--that two grams would be enough for 200,000 doses. Durovic has recently announced making his first U.S. batch of 200 mg. from 200 horses.

What Krebiozen is, or even whether exists, has been impossible to establish by impartial analysis because of another whodunit circumstance. In early 1951 Ivy and Durovic were worried about the stuff's keeping qualities. Somebody mentioned casually that perhaps it would keep better in oil. Straightway, Durovic dumped his whole supply into light (pharmaceutical grade, No. 9) mineral oil. The dilution is so great that the presence of the drug can no longer be proved. And of course its chemical composition was smothered under the gusher of oil.

Fungal Process. By all odds, a man of Ivy's standing should have wriggled out of the mess as soon as he found what he was in. But Andrew Ivy is as stubbornly devoted to any cause he espouses as he is to his vigorous Methodist faith. Difficult to deal with he certainly is.

Dr. Ivy has studied the secretive Dr. Durovic's method of injecting into horses a preparation of killed and sterilized fungi,* waiting for the horses' systems to react, then bleeding them and extracting Krebiozen from their blood serum by a highly involved process. He has duplicated the process and has a vial containing a few milligrams of an off-white powder which he believes is identical with Durovic's Krebiozen. Ivy has also worked on Krebiozen's chemistry. It is, he declares, a "tissue hormone" secreted by the RES cells. If Krebiozen is indeed a tissue hormone, he has a better chance of getting it licensed.

Finally, Dr. Ivy has continued to treat patients, usually in his laboratory or office. Through it all, Ivy has amassed data which, he asserts, prove Krebiozen's effectiveness against certain types of cancer. He also relies heavily on the practice of two Chicago physicians (with whom he co-authored a 1956 book): Dr. John F. Pick, a plastic surgeon, and Dr. William F. P. Phillips, a general practitioner.

A burly, down-to-earth pragmatist with an earthy vocabulary, Dr. Phillips, 48, has given Krebiozen to about 300 patients --more than any other physician. He keeps aloof from the charges and countercharges about Krebiozen. He is convinced that Krebiozen helps his patients. But he frankly admits that he cannot be sure. He has neither the training nor the time--, to become a research scientist, he says.

When Hope Is Gone. Medical orthodoxy requires that before a new drug gets a formal, elaborate, wide-scale test, there must be a prima-facie case in its favor from the records of patients already treated. Dr. Ivy's cases are too few for that. The Krebiozen Foundation's records are too sketchy. So, for the New York Post, two newsmen took turns sitting down with Dr. Phillips and going through his cases. From the first 67, it was clear that no conclusive findings as to the value of Krebiozen would emerge even if all 300 were analyzed.

Sometimes a reported improvement is what the doctors call "subjective," meaning that the patient feels better, says he has less pain, eats better and often resumes normal activities after having been bedridden. Cancer scientists dismiss all such effects as resulting from the power of suggestion.

But there remain, says Dr. Phillips, a few patients whose diagnosis of cancer was proved by exacting laboratory techniques and who then lived longer than the majority of patients with similar disease. In some of them, the cancer process actually seemed to have been arrested or even reversed. Could this be chance?

The most determinedly anti-Krebiozen spokesman for a leading U.S. cancer research center admits that not all of these cases can be explained away by other factors, though he still insists there is no reason to test Krebiozen further. Another expert, equally skeptical but more judicial, says: "From these cases, you can't help feeling there's something here that needs to be explained." This jibes with Dr. Phillips' tenet: "If the researchers in their ivory towers would stop bickering and get down to work, we could have some valuable information within a year, and a definite answer before too long."

Last week, the New York Post made its own proposal to break the stalemate: The National Cancer Institute should quit making favorable prior evaluation a condition, because adequate data simply do not exist. Ivy should be allowed to determine the drug dosage, because of his experience, but should not be on the evaluating panel.

Krebiozen may be no cure or even palliative for cancer of any kind, but a fair test would cut out most of the cancer of the Krebiozen controversy.

* From the Latin for a "little net" of tissues lining the blood vessels. The ones that produce white blood cells and (presumably) other defenses against disease are in the spleen, lymph nodes and liver. * Actinomyces bovis, cause of the disease "lumpy jaw" in cattle.

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