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From the Townsend Letter
December 2009


War on Cancer
Simoncini's Bicarbonate Treatment for Cancer
by Ralph Moss, PhD

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There is a doctor in Italy, Tullio Simoncini, MD, who has roiled the waters of oncology by claiming that all cancers are actually outbreaks of fungal disease. He has written a book to this effect, Cancer Is A Fungus, and also produced websites and online videos expounding his theories. His work is discussed at almost 50 000 websites.

Basically, Simoncini's main claims are as follows:
1.  Cancer is actually an opportunistic fungal infection of the common form of yeast Candida albicans.
2.  Tumors are therefore not composed of human cells, but are invasive colonies of Candida.
3.  One proof of this is that cancer is invariably white in color, since Candida is also white (the word albicans itself means "white body.")
4.  Cancer can be successfully treated with sodium bicarbonate (baking soda), one of the least expensive products in the entire pharmacopoeia.

For many people, the Simoncini controversy is in essence a battle between conventional and complementary and alternative medicine (CAM), and they take sides accordingly. Simoncini casts himself as a heroic opponent and victim of Big Pharma. The "quack busters," who also abound on the Internet, use various weaknesses in Simoncini's argument to make sweeping attacks against what they call "s-CAM." According to many websites, Simoncini lost his medical license in Italy in 2003 and in 2006 was convicted of manslaughter, due to the death of a cancer patient. This of course led to an increase in the acrimony around the whole concept of the bicarbonate treatment of cancer.

My own opinion is that Simoncini is fundamentally wrong in most of his theories. However, as I shall show, there may be some merit, at least potentially, in the use of bicarbonate as a cancer treatment.

As to the theory of cancer's origins, there are major deficiencies. Let us take Simoncini's claim that cancer is always white in appearance. What then about the skin cancer known as malignant melanoma? This is anything but white. In fact, the name melanoma means a tumor containing dark pigment. If we follow Simoncini's logic, either melanomas are not cancers, or else all cancers are not white. Yet melanomas are real cancers and can be deadly. They will afflict over 68 000 Americans this year and kill 8650.

If we look at the more common cancers, many of them are indeed white in their interior portions. But so too are many other parts of the body that are not connected to cancer (bones, nails, some people's skin, etc.). So being white is not proof of being cancerous. More importantly, one can easily demonstrate that cancers are not fungi but human cells gone awry. The two kinds of cells are dramatically different, not just in their appearance but in their genetic makeup (genome). Candida albicans is a unicellular member of the Saccharomycetaceae family. It is present in a harmless form in 80% of human beings, although under certain pathological conditions can become the source of various diseases (such as thrush).

Starting in October 1996, the genome of C. albicans was sequenced at the Stanford DNA Sequencing and Technology Center and the Broad Institute of MIT and Harvard University. The entire diploid genome sequence of Candida albicans was published in the Proceedings of the National Academy of Sciences (PNAS) in 2004 and is available online. The DNA of a fungus is, of course, radically different from that of a human being. Yet, to my knowledge, every study of the DNA of cancer cells (and there are thousands) points to their human origin. If they were of fungal origin, wouldn't this be immediately evident to every competent pathologist in the world?

An Old Idea
For these and other reasons, I do not believe that Simoncini's basic theory of cancer's origins has merit. However, this faulty theory needs to be sharply delineated from his proposed treatment, which is the application of a solution of sodium bicarbonate, particularly to the site of the tumor. After all, it is possible that his Candida theory could be wrong and yet his proposed treatment could be effective. Or, as E. K. Sander wrote, in reference to a different scientific controversy, "Therapy results add notoriously little to resolution of competing theories, since they too are capable of diverse explanations" (1975).

The theory that cancer is acidic, and can be combated with some sort of antacid solution, is not original to this Italian doctor. It is a very old idea. In 17th-century Germany, according to James Ewing, MD, in his classic Neoplastic Diseases, "Chemical conceptions [of cancer] held sway, and cancer was attributed usually to excess of acid, to be treated with alkalai" (1942). This, says Ewing, was the theory of J. B. Van Helmont (1579–1644) and Michael Ettmüller (1644–1683).

It is a common observation, and in no way limited to the work of Simoncini, that tumors tend to exist and thrive in an acidic environment. One of the key reasons for this is the "Warburg effect"; that is, the production of lactic acid by cells breaking down glucose through glycolysis. Prof. Ian Tannock and his colleagues at the University of Toronto have written: "Solid tumors have been observed to develop an acidic extracellular environment." This "is believed to occur as a result of lactic acid accumulation produced during aerobic and anaerobic glycolysis." However, these authors also point out that lactic acid production is "not the only mechanism responsible for the development of an acidic environment within solid tumors" (Newell 1993). Another mechanism might be the poor perfusion of blood around tumors (Robey 2009).

For more than a decade there has been very interesting work going on at the University of Arizona, using bicarbonate as a potential treatment for cancer. Robert J. Gillies and his colleagues have demonstrated that pretreatment of mice with sodium bicarbonate results in the alkalinization of the area around tumors. This "enhances the anti-tumor activity" of two anticancer drugs, doxorubicin and mitoxantrone, in two different mouse tumor models (Raghunand 2003).

An acidic pH has been shown to stimulate tumor cell invasion and metastasis in animal models. In March 2009, the same group reported that bicarbonate makes tumors more alkaline and also inhibits spontaneous metastases (Robey 2009). The question was whether inhibition of tumor acidity would reduce the incidence of metastases. The authors showed that oral sodium bicarbonate increased the pH of tumors and also reduced the formation of spontaneous metastases in mice with breast cancer. It also reduced the rate of lymph node involvement, yet it did not affect the levels of circulating tumor cells (Robey 2009).

At various Simoncini proponent websites, however, this is already being hailed as a confirmation of the Italian doctor's theories. But, as I have shown, Simoncini did not originate the theory that cancer is acidic in nature, nor the very old idea of using alkaline substances in its treatment. So I don't think that he can claim this work now, nor does it sanction patients to abandon potentially more effective treatments in order to seek sodium bicarbonate injections under what could be dangerous conditions. There is no comparison, for instance, between this poorly documented treatment and the much better-founded CAM treatments (such as hyperthermia) given at the best German clinics.

It is indeed striking that in these Arizona experiments, the oral administration of bicarbonate was able to reduce the spontaneous formation of metastases in mice with breast cancer. This is impressive work that needs to go forward. However, it does a disservice to patients to identify these important scientific findings with the unsubstantiated theories of Dr. Simoncini regarding the supposed fungal nature of cancer.

Grapes to the Rescue
If you own a vineyard, this has been a very good season. A new study showed that people over 60 who consume a moderate amount of alcohol had less risk of dementia, including Alzheimer's disease. In some categories, the risk reduction was almost 50% (Anstey 2009). Less well publicized, but also encouraging, was a recent study suggesting that dark-skinned grapes might help those undergoing radiation therapy (Ramos de Andrade 2009).

The Brazilian authors tested black grape juice as a protector against the ill effects of radiation in Wistar rats. Sixteen animals got varying degrees of whole-body radiation. Half were given a placebo sweet water drink, while the other half were allowed to drink their fill of grape juice for one week before and two weeks after radiation. There was significant liver weight loss in the placebo group, while in the grape juice group their livers stayed normal. Also, in the placebo group, there were the typical abnormalities of the blood after exposure to ionizing radiation exposure, including early leucopenia and anemia. But the intake of grape juice "induced an increase in granulocyte percent count" (Ramos de Andrade 2009).

I realize that the benefit was seen in albino rats, not people. But perhaps this is an acceptable compromise to those oncologists who are so concerned that an antioxidant supplements will undo the beneficial effects of radiation therapy. After all, what harm could they imagine in adding grape juice to one's diet, especially before or after receiving powerful radiation therapy?

Note: The Brazilian study used black-skinned grape juice. I don't find any such product on the market in the US. But one can probably safely substitute a dark grape juice, such as that derived from Concord grapes (Vitis labrusca).

More Good News About Green Tea
People began to suspect that green tea had anticancer properties when they realized that Chinese people generally have less cancer (especially breast cancer) than most Westerners. When you are in China, you see traditional people from the countryside carrying bottles of green tea the way Westerners carry soda. As scientists investigated further, they found that green tea (the unfermented form of Camellia sinensis, which is more familiar to Westerners as black tea) contains compounds called polyphenols, including one called epigallocatechin gallate (EGCG). There have been a lot of speculation and laboratory studies on the antioxidant and anticancer properties of EGCG, but little clinical work.

All that is changing. The news on green tea continues to be positive. There was recently a small clinical trial of Polyphenon E, a standardized form of EGCG, which showed surprisingly strong effects on chronic lymphocytic leukemia (CLL). The study was published in August in, of all things, the very orthodox Journal of Clinical Oncology (Shanafelt 2009). This summer, the Food and Drug Administration (FDA) granted Polyphenon Pharma of New York City "orphan drug status" for Polyphenon E in the treatment of CLL. This gives the company seven years of marketing exclusivity for the product. It brings Polyphenon one step closer to formal drug approval.

CLL is a kind of leukemia found most frequently in older individuals. It is characterized by an excess of lymphocytes (a kind of white blood cell). As the name implies, it is a slower-growing form of blood cancer than the acute or pediatric forms of the disease. While patients generally survive a long time with CLL, ironically it is also less curable than some of the more aggressive forms of leukemia. A recent article, authored by Tait D. Shanafelt and a dozen or so coworkers at the Mayo Clinic (Rochester, MN), concerned 33 patients treated with one of eight different dose levels of EGCG. These ranged from 400 to 2000 mg of EGCG, taken twice per day. One of the patients experienced a partial remission of cancer. Also, within one month of starting treatment, 11 patients (33%) had a sustained 20% or greater decrease in their lymphocyte count. Eleven out of 12 patients who had palpable lymph nodes experienced a reduction of at least 50% in the size of these nodes during this brief course of treatment.

The adverse effects were minimal and nothing like what is seen with most chemotherapy. The most frequent side effect (in 33%) was a mild case of transaminitis, a condition that indicates stress to the liver. There was mild abdominal pain in 30%, and mild nausea in about half the patients.

A phase 2 trial of Polyphenon E in CLL is now underway. In this trial, all test subjects will get the top dose of Polyphenon E, which is 2000 mg twice per day. For those who cannot wait for the FDA to approve this product (and, based on past experience, the process could take years) – well, EGCG is available in the market. The trouble is that most brands contain only 250 to 400 mg per capsule; thus one would need to take 10 to 16 capsules per day to reach what is apparently the optimum dose. Given the fact that there were some adverse effects in some of the cases, I would strongly suggest that you only do this under the guidance of a CAM-oriented physician. For those looking to prevent CLL, as well as other forms of cancer, enjoying a variety of organic green tea products daily might be just the ticket.

Anstey KJ, Mack HA, Cherbuin N. Alcohol consumption as a risk factor for dementia and cognitive decline: meta-analysis of prospective studies. Am J Geriatr Psychiatry. 2009;17:542–555.

Ewing, James. Neoplastic Diseases. 4th ed. Philadelphia: Saunders; 1942:3.

Jones T, Federspiel NA, Chibana H, et al. The diploid genome sequence of Candida albicans. PNAS. May 11, 2004;101(19):7329–7334. Available at:

Newell K, Franchi A, Pouysségur J, Tannock I. Studies with glycolysis-deficient cells suggest that production of lactic acid is not the only cause of tumor acidity. Proc Natl Acad Sci U S A. 1993;90:1127–1131.

Raghunand N, Mahoney BP, Gillies RJ. Tumor acidity, ion trapping and chemotherapeutics: II. pH-dependent partition coefficients predict importance of ion trapping on pharmacokinetics of weakly basic chemotherapeutic agents. Biochem Pharmacol. 2003;66:1219–1229.

Ramos de Andrade E, Da Costa Escobar Piccoli J, Mânica da Cruz IB, et al. Radiomodifying effect of organic grape juice supplementation on hematological parameters and organ weight in whole-body X-irradiation in rats. Nutr Hosp. 2009;24:297–303.

Robey IF, Baggett BK, Kirkpatrick ND, et al. Bicarbonate increases tumor pH and inhibits spontaneous metastases. Cancer Res. 2009;69:2260–2268.
Sander EK. Untangling stuttering: A tour through the theory thicket. ASHA. 1975;17:256–262.

Shanafelt TD, Call TG, Zent CS, et al. Phase I trial of daily oral Polyphenon E in patients with asymptomatic Rai stage 0 to II chronic lymphocytic leukemia. J Clin Oncol. 2009;27:3808–3814.

Simoncini T. Cancer therapy [website].

Ralph W. Moss, PhD, is the author of 12 books on cancer-related topics. The former science writer at Memorial Sloan-Kettering Cancer Center, for 35 years Moss has investigated the validity of many cancer treatments. He currently directs the Moss Reports, a library of reports for patients on over 200 different cancer diagnoses.


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