A visit to the IAT clinic.
In March 2011 I visited the Immune Augmentative Therapy (IAT) Centre in Freeport, Bahamas. I first visited this clinic in 1980 and have been back periodically since then. I found an efficiently run clinic with a unique treatment approach. As always, I interviewed John Clement, MD, the long-time medical director, as well as his designated successor, Kevin Bethel, MD. Bethel is a seventh-generation Bahamian and a McGill graduate who practices family medicine with a holistic orientation. I also interviewed the other employees of the clinic, some of whom have been there since its beginnings in the 1970s.
In my book The Cancer Industry, I told the story of Lawrence Burton, PhD, and his founding of the IAT clinic. There was and is great skepticism about the motives and results of this clinic, which persisted even after Burton's death a dozen years ago. The key question, of course, is whether the clinic ever achieves results in situations that are otherwise deemed helpless. I believe that it sometimes does--although I have no way to measure how often that occurs.
Confirmation of the utility of the treatments also comes from a report prepared for the Agency for Healthcare Research and Quality (AHRQ), part of the Department of Health and Human Services (DHHS). The AHRQ was created in 1989 and reauthorized under its present name in 1999. With a staff of 300, it has an annual budget of $329.6 million.
Its report on IAT was published in April 2003 but generated little attention at the time. It was prepared by the Southern California Evidence-Based Practice Center. This center, which itself dates back to 1972, began as the RAND Corporation's Health Insurance Experiment. (http://www.ahrq.gov/clinic/epc/socalepc.htm)
The principle authors of the AHRQ report were Prof. Ian Coulter, PhD, the Samueli Institute Chair in Policy for Integrative Medicine and senior health policy analyst, at the RAND Corporation and Mary Hardy, MD, medical director of the Simms/Mann UCLA Center for Integrative Oncology at the University of California at Los Angeles. Dr. Hardy graduated from Tufts New England Medical Center in 1984 and also studied medical ethics at Harvard Divinity School and Loma Linda University. There were other expert reviewers as well. (The full report citation is given below.)
The authors reviewed 30 cases that they considered to have the potential to be included in a best-case series (BCS). Of those, nine cases were finally presented that they considered the most complete or appropriate in terms of National Cancer Institute (NCI) criteria for a best-case series. These included the following types of cancer:
1. Hodgkin's lymphoma,
2. nodular lymphoma (poorly differentiated),
3. non-small cell carcinoma of the lung,
4. abdominal mesothelioma (two cases),
5. ovarian adenocarcinoma,
6. squamous cell carcinoma of vocal cord (two cases), and
7. colon cancer
Here is a brief discussion of half a dozen of these cases (using the case numbers utilized by the AHCQ report).
* Patient #1, nodular sclerosing lymphoma stage IB. After presenting with superior vena caval obstruction, this 46-year-old male was diagnosed on 12/2/83 with nodular sclerosing lymphoma stage 1B. He had palliative radiation therapy, which was completed on 12/7/83. He underwent chemotherapy from 12/83 to 6/84. After his chemotherapy a 7/10/84 CT scan revealed that he still had a superior mediastinal mass. He began IAT on 8/2/84 and completed 22 courses of immune therapy. He also took a variety of dietary supplements. Serial chest x-rays taken during IAT showed a decrease in tumor mass. An MRI report on 11/4/86 showed "inactive disease." A 1995 MRI of the chest also showed inactive disease. When interviewed on 9/26/01, he reported that his overall physical condition to be excellent.
* Patient #3, squamous cell carcinoma of the right vocal cord and anterior commissure. This 68-year-old male was diagnosed with squamous cell carcinoma of the right vocal cord and surrounding area on 9/3/81. An incomplete excisional biopsy was performed. The patient refused radiation therapy. Thus, this patient never received definitive conventional therapy. From 9/22/81 to 5/19/89, he completed 15 courses of IAT. Serial examinations by an otolaryngologist revealed the persistent presence of disease without progression through 2/23/82. An otolaryngologist performed an indirect laryngoscopy on 7/20/94, which did not reveal any abnormal findings. At the last contact (interview, 9/24/01), the patient reported that his overall physical condition was very good to excellent.
* Patient #4, metastatic non-small cell carcinoma of the lung. This 67-year-old woman was diagnosed with metastatic non-small cell carcinoma of the lung in July 1992. She presented with swelling in the neck, an enlarged lymph node, and a chest mass demonstrated by CT in the area of the aorta. A mini-thoracotomy identified a mass as poorly differentiated non-small cell lung cancer (NSCLC). The patient completed palliative chemotherapy and radiation. No response was demonstrated to these treatments, and no further conventional therapy was advised. She began IAT in February 1993 and was on maintenance therapy at the time of the AHCQ report. Serial CT scans beginning in September 1994 revealed resolution of the tumor. At the last contact (interview, 12/4/01), the patient reported her overall physical condition as good.
* Patient #6, poorly differentiated nodular lymphoma. This 49-year-old man was diagnosed in 1983 with poorly differentiated nodular lymphoma after presenting with an enlarged node on his chin, fever, night sweats, and generalized pruritus. He was diagnosed with stage II disease. Local radiation was not recommended, while chemotherapy was deferred awaiting progression of disease. By 2/1/84, the patient had palpable disease in both axillae (armpits). He started IAT on 2/14/84 and completed 12 courses by 7/19/90. As of 11/07/01 he was in remission and reported his overall physical condition as excellent.
* Patient #7, peritoneal mesothelioma. This 50-year-old white woman presented with a history of peritoneal mesothelioma, which was initially misdiagnosed as ovarian cancer. She had extensive surgery followed by Taxol-carboplatin chemotherapy, which was begun on 7/28/99. She had an anaphylactic reaction to Taxol and so chemotherapy was discontinued. On 8/5/99, her biopsies were reviewed at the Armed Forces Institute of Pathology, which changed the diagnosis to peritoneal mesothelioma. No other conventional therapy was pursued, IAT was started on 12/1/99 and continued, with her most recent treatment on 6/6/01. Serial pelvic CT scans reveal a gradual diminution of pelvic densities, with the pelvic CT scan on 5/24/01 revealing no evidence of progressive tumor or other abnormality. At last contact, the patient reported that her overall physical health was good.
* Patient #9, ovarian cyst adenocarcinoma. The patient was a 54-year-old woman with an ovarian adenocarcinoma diagnosed on 5/3/80. She had a total hysterectomy. She was referred for chemotherapy but refused. Her only therapy consisted of 34 courses of IAT from 6/3/80 to 6/12/99. In June 1987, a CT scan revealed lesions in her liver that were suspicious for metastatic disease. A liver biopsy was recommended, but none was performed. Subsequent follow-up did not reveal progression of disease. A pelvic mass was noted on 8/6/00 and found to be increasing over the next year to a maximum size of 2.8cm x 2.8cm. An exploratory laparotomy with resection of left pelvis mass and biopsy of right pelvis was performed on 6/29/01, but pathology from the surgery was negative for cancer. Tumor markers have also been negative. Routine gynecologic care has not revealed any abnormalities. At last contact the patient reported that her overall physical health was good.
Over the years the IAT clinic has added a number of new treatments, such as GcMAF, dendritic cells, and stem cell treatments. But lately they have gone back to their roots, which are in Burton's original concepts. I will therefore focus on IAT, a treatment approach that is unique to this clinic. It involves the interaction of four elements: (a) blocking protein, (b) deblocking protein, (c) tumor antibody, and (d) tumor complement.
Some of these terms are familiar to orthodox cancer researchers. Tumor antibody was Burton's term for a form of gamma globulin (IgG) as well as some related immunoglobulins (IgA and IgM). Blocking factors are commonly accepted scientific concepts. M. Rigdon Lentz, MD, of Prien, Germany, has elaborated on the nature of some of the blocking factors involved in cancer, which he codiscovered when he was a professor at the University of California, Irvine (Gatanaga 1990).
Similarly, unblocking, or deblocking, factors, such as alpha-2-macroglobulin (sometimes called A2M), which Burton claimed caused the sensational remissions in mice, have also been frequently posited by scientific researchers. It is normally produced in the liver and serves as an inhibitor of coagulation. A study from Leipzig showed that a form of A2M was associated with "an inhibition of tumor cell proliferation, migration, invasion, spheroid formation, and anchorage-independent growth" in brain cancer (Lindner 2010).
In 1974, Burton, a laboratory scientist, was offered a chance to test his approach on human patients. With the help of wealthy supporters, he and Friedman left St. Vincent's Hospital and founded the Immunology Research Foundation in Great Neck, New York. Burton administered an immune competence blood test to determine the levels of blocking protein and other factors, and medical doctors affiliated with the new foundation began to treat cancer patients with a sequence of the various blood components.
In July 1974 New York magazine ran a front-page story on the two Long Island researchers. The cover of this widely read magazine showed Burton and Friedman holding out a C3H(t) mouse for the inspection of the general public (Anderson 1974).
Modern Medicine reported that 11 New York-area doctors, including some physicians at Downstate Medical Center, expressed great interest in participating in a clinical protocol if Burton's Immunology Research Foundation's request was approved. That was January 1, 1975. But trials never began. There are radically different versions of why human tests of Burton's method did not come to pass. According to a NCI press release at the time, Burton was asked to answer several questions by the Food and Drug Administration (FDA). "No response to these questions was ever received. Consequently, Immunology Research Foundation's IND application was not accepted by the FDA and was withdrawn at the request of IRF on March 8, 1976" (NCI 1978).
Burton told a different story: First the FDA sent back his request with three questions. Burton answered the questions and then prepared for trials to begin. But the FDA responded with more questions, three pages of them, single-spaced. "It became apparent that the FDA regulations and the National Cancer Institute (NCI) protocols would take too long" (Burton 1979).
Burton next took a very radical step for a laboratory scientist: in 1977 he moved his operation to the Bahamas and established a research/treatment center adjacent to the Rand Hospital, on Grand Bahamas Island. The clinic is a one-story building within the grounds of the hospital, with a modern waiting room, treatment rooms, and several spacious laboratories where the blood fractions are prepared and (in those days) laboratory animals were tested. Burton's method in the Bahamas, renamed Immuno-Augmentative Therapy (IAT), was basically the same as it was in Great Neck, but on a larger scale.
During the early years Burton administered the blood tests using a computer to keep track of the patients' blood profile. A physician colleague then administered blood fractions, derived from normal human blood (serum) flown over from the mainland. Burton claimed that he offered these fractions "only after they [had] been fully tested for toxicity and efficacy in the strain of spontaneous tumor mice."
But how successful was Burton in the Bahamas? It is still impossible to give a definite answer to this question. His follow-up on thousands of patients was poor, since patients came from--and returned to--places all over the US, and even the world. What is more, Burton did not publish any clinical results; in fact he did not publish any scientific papers after the mid-1960s.
A follow-up report on 227 patients who were treated at the clinic in 1977 showed that at least 18% had survived in good health five years later. The expected survival rate, based on SEER data in equivalent patients, was less than that, although selection bias could distort the results.
"We don't have a cure-all," Burton always cautioned. As of the late 1970s, the best results had been claimed in cases of prostate cancer, malignant melanoma, bladder cancer, and some head and neck tumors.
Over the years I got to know Burton well, and it always stirs my emotions to see the excellent portrait of him that hangs in the patients' waiting room today. He had a unique and at times an irascible personality and rubbed many people the wrong way. However, that is ancient history, and besides, that sort of sentiment should be separated from the question of the efficacy of his treatment. My own impression, after five or six visits spaced over three decades, is that this treatment is sometimes very effective, especially in terms of secondary prevention. The AHCQ report certainly bears that out. But I have long ago stopped expecting carefully tabulated data, much less randomized controlled trials (RCTs), anytime soon. If one can accept these limitations, this could be a good treatment option, especially for patients coming from the East Coast of the US.
Anderson A Jr. The politics of cancer: why won't the medical establishment pay attention to these two men; New York. July 29, 1974.
Cameron/Friedlander, Immunology Center--Cancer Release. Ft. Lauderdale. FL; 1979.
Gatanaga T, Hwang CD, Kohr W, et al. Purification and characterization of an inhibitor (soluble tumor necrosis factor receptor) for tumor necrosis factor and lymphotoxin obtained from the serum ultrafiltrates of human cancer patients. Proc Natl Acad Sci USA. 1990;87(22):8781-8784.
Lindner I, Hemdan NYA. Buchold M, et al. Alph2-macroglobulin inhibits the malignant properties of astrocytoma cells by impeding beta catenin signaling. Cancer Res. 2010;70(l):277-287.
National Cancer Institute. Statement on Lawrence Burton/Immunological Research Foundation. Bethesda, MD, April, 1978.
Best-Case Series for the Use of Immuno-Augmentation Therapy and Naltrexone for the Treatment of Cancer. Summary, Evidence Report/Technology Assessment: Number 78. AHRQ Publication Number 03-E029, April 2003. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/clinic/epcsums/immaugsum.htm The report can also be accessed through PubMed: http://www.ncbi.nlm.nih.gov/books/NBK36952.
by Ralph Moss, PhD