Letter from the Publisher

Townsend Letter Index

For years our subject and author index was available, like the magazine, only on paper. With our first website we published the index online, but one would still need to find the article in the print magazine. In the last year www.townsendletter.com has been entirely redone. Not only are the current and previous issue contents easily accessible but recently posted articles, best reads, and a blog post are all available on the home page. Thanks to the work of our index editor, Jule Klotter, and our webmaster, Joy Reuther-Costa, the index has now been completely updated and made easily accessible with a simple click on the banner tool bar.

The article you read a year ago may not be so easily remembered, but you can quickly search the index on our website. If the article is online, a simple click will bring the article up for fast review. We have also created an index of keywords for examining articles from past issues. Give a look-see of our website in the near future and be sure to include inspection of the newly accessible index.

Bioinformatics Tools for COVID-19 Management by Peter D’Adamo, ND

Over the past several months we have had a “deluge” of contributions from writers and readers about COVID-19. While many of these articles have appeared in the print and e-edition of the Townsend Letter, we have published others online only on our website, www.townsendletter.com (accessed by clicking on the “New Coronavirus Reports” green tab at top of the website.) Located half-way down this page of diverse, colorfully illustrated article tabs is one labelled: “Generativity: Bioinformatics Tools for COVID-19 Management by Peter D’Adamo, ND.” I have given you these directions to find his article rather than a simple link because D’Adamo’s interactive article will also ask for your step-wise participation. Located all in one place, using an AI-structured, algorithmic, data-based program, practitioners are invited to key in patient diagnostics and best-evidenced therapeutics are mapped out for treatment of COVID-19. The data powered by datapunk.net is updated continuously and hyperlinked journal references are immediately accessible for review. While D’Adamo’s bioinformatics tool has been posted for many months, we have neglected to give it its fair due in the print magazine. This is my request for you to take the effort to go to our website and access his column and spend some time learning how to “play” with this very well researched, physiological-mechanism-based, evidence-rated compendium of pharmacological and herbal treatments for COVID-19 and related viruses.

One reason that this article was posted online rather than printed is that “bioinformatics” works infinitely better on a screen than on a paper page. It may be ideal, if possible, to use two devices, a phone and a laptop or tablet, so that while the article is being read, the datapunk site can be viewed simultaneously. If nothing else the tabulated table of putative coronavirus agents that include some 100 drugs, herbs, and vitamins is a wealth of information. Each agent is hyperlinked to a Wikipedia entry providing an immediate description of drug or herb. Each agent is rated as to its effective activity against COVID-19 as well as corona, influenza, herpes, HIV, and hepatitis viruses. The evidence is rated as evidence-based, observational, case report, in-vitro testing, and speculative. The reference for the evidence is accessible for immediate reading directly from the table—this enables comparison of drug vs drug and herb vs herb as well as drug vs herb.

Using D’Adamo’s tool allows the user to enter clinical data about an individual patient. Symptom entries include temperature and symptoms such as myalgia, chills, cough, fatigue, dyspnea, dermatitis, oxygen saturation, heart rate, and more. Based on symptom entry the program identifies the stage of illness and then determines the top therapeutic indications graded by stage. Therapies are differentiated into those having highest level of significance, lower level of significance, possibly contraindicated, and requiring watchful monitoring. And indication strength of 1.0 would be absolutely indicated, a strength of 0.0 would be not indicated whatsoever. The therapeutic indications for the specific patient are then listed in numerical order with ratings of 1.0-0.0 (highest to lowest). Each remedy is sorted for stage of illness and symptom specificity.

The ultimate bioinformatics tool is a “Requisite Variety Matrix,” which appears as a spatial diagram. The matrix separates out several key physiological mechanisms that offer best synergistic support. Each therapeutic is spatially linked linearly to its key synergistic mechanism. The value here is that the AI-based algorithm is delineating therapeutics based on the patient’s diagnostics.

Is this the future of medicine—are we going to enter diagnostic symptoms and an AI-based program will determine best-evidence based treatment? Perhaps. One thing that separates D’Adamo’s tool is that he includes herbals with drugs; in certain cases, an herb offers as much support as a drug. It is doubtful that medical academia will include herbals in their algorithm tools.

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Erectile Dysfunction: The Canary in the Cardiovascular Coalmine?” by Erica Zelfand, ND

Not too long ago, Viagra and Cialis were the most widely advertised pharmaceutical products in print and on television. Both are phosphodiesterase inhibitors, which are effective in helping a man with ED develop an erection. However, they are a temporary solution only—when not used, the erectile dysfunction persists. Over the past decade “low-T” (low testosterone) treatment has become the panacea for loss of vitality as well as ED. Clinics dedicated to diagnosing and treating low-T have sprung up throughout the US and internationally. While testosterone has proven to be unsurpassed in “awakening” grumpy old men, it has not been nearly as successful in reversing impotency. Hence, many low-T treated men still require Viagra or Cialis to take care of business in the bedroom. But is there a better solution for ED?

Erica Zelfand, ND posits that the approach we focus upon in managing erectile dysfunction ignores the role that nitric oxide plays in tumescence (penile erection). NO is the principal molecule that enables the relaxation of the cavernous musculature permitting the blood engorgement of an erection. Like testosterone, NO levels decrease as one ages. Nitric oxide can be nutritionally increased by eating foods abundant in nitrates such as beets. However, dietary nitrates require bacteria in the mouth to convert nitrates to nitrites. Further without adequate hydrochloric acid in the stomach, nitrites may not convert to nitric oxide.

Concurrently NO can be synthesized from the amino acid, L-arginine. The enzyme nitric oxide synthase, which converts arginine to NO depends on multiple co-factors emphasizing the need for nutritional management, exercise, and improving overall cardiovascular health.

Zelfand’s article is an excellent primer to share with men who fail to take their health seriously.

Cover Story: Nicholas Gonzalez, MD

Before the 2000s, cancer care was largely based on surgical excision, radiation treatment, and chemotherapy. This was before immunotherapy, biological treatments, and targeted therapy. Despite cheerleading by the American Cancer Society, long-term survival with nearly all cancer diagnoses was uniformly poor if the malignancy progressed beyond a Stage 1 tumor. As would be expected alternative cancer therapies developed here and abroad. While clinics in Germany and Mexico integrated conventional and alternative cancer therapies, alternative cancer centers in the US largely offered proprietary therapies independent of conventional care. Quackbusters, including hematologist Victor Herbert, MD, decried alternative cancer treatments, labelling practitioners as quacks.

Politically the public who wished the freedom of choice to seek out alternative care demanded Congress to investigate why such treatment was being attacked by medical boards, the AMA, and the ACS. In 1987 the Office of Technology Assessment (OTA) set up a study of unconventional cancer treatment. Despite the lackluster characterization of such treatments by the OTA, Congress appropriated funding in 1991 for an Office of Alternative Medicine at the NIH; that office became the National Center of Complementary and Alternative Medicine at the NIH.

Among the many cancer protocols and practitioners the OTA examined was the work of Nicholas Gonzalez, MD, a treatment protocol based on specialized diet, extensive supplementation including high dose pancreatic glandular supplements, and complementary treatments such as coffee enemas. While Dr. Gonzalez died in 2015, his treatment protocol continues to be administered by practitioners, for example, Linda Isaacs, MD. This month Gonzalez’s authorized biography, The Maverick M.D.—Dr. Nicholas Gonzalez and His Fight for a New Cancer Treatment by Mary Swander, has been published. An excerpt from the biography appears in this issue together with a special report for the Townsend Letter by Swander of her experience being treated by Gonzalez.

Gonzalez’s protocol was based largely on the work of a renegade dentist, William Donald Kelley, who putatively survived a diagnosis of pancreatic cancer with a metabolic-based diet and high doses of glandular pancreatic enzymes. (See Carrie Decker’s article from Aug/Sept 2019: “Pancreatic Glandular Therapies: From Absorption to Cellular Interaction in Cancer” at www.townsendletter.com). Unlike Kelley, Gonzalez was an individual soundly trained in medicine and science completing post-graduate work with renowned immunologist Robert A. Good, MD, at Sloan Kettering Cancer Center and at the University of Oklahoma. Gonzalez decided in 1987 to devote his energies to perfecting the Kelley protocol, necessitating his decision to step away from conventional cancer centers who were unwilling to welcome his use of unconventional cancer care.

The National Cancer Institute and NCCAM did fund an experimental study comparing a chemotherapeutic agent, Gemcitabine, with Gonzalez’s regimen of specialized diet and pancreatic enzyme therapy in patients with advanced pancreatic cancer. The results, unfortunately, did not prove efficacy of Gonzalez’s approach; the NIH report showed survival in the Gonzalez treatment group was four months compared to 14 months in the Gemcitabine group. Gonzalez decried the study design and the statistical analysis; when he requested investigators at Columbia University review the study, he was stunned by their confirmation in 2009 condemning the treatment effectiveness. Gonzalez subsequently authored a book denigrating the reports faulty analyses and conclusions—the excerpt from Swander’s book in this issue details Gonzalez’s plight with the university investigators and the NIH.

Does a specialized diet and glandular enzymes play a role in cancer care in 2020? Despite the blanket condemnation offered by Wikipedia of Gonzalez’s regimen, patients still need alternative cancer options now. Survival for most advanced cancers may have been modestly improved in the past decade with expensive immunotherapies, but five-year survival rates remain low. Unless a patient is content with limiting oneself to only what is available in “evidence-based” medicine, quality-based long-term survival will necessitate alternative treatment interventions. Not everyone benefits using the Gonzalez approach, but everyone should be permitted the freedom to use it when no other options are forthcoming.

Jonathan Collin, MD